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glycopyrrolate

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Description

Glycopyrrolate is a synthetic anticholinergic drug used to treat various conditions, including overactive bladder, chronic obstructive pulmonary disease (COPD), and Parkinson's disease. It is a quaternary ammonium compound that acts as a muscarinic antagonist, meaning it blocks the action of acetylcholine at muscarinic receptors in the body. Glycopyrrolate is typically administered orally or by inhalation.

Glycopyrrolate is often preferred over other anticholinergic drugs for its long duration of action and low incidence of side effects, such as dry mouth and blurred vision. However, like all drugs, it can have potential adverse effects, so it is important to talk to your doctor before taking glycopyrrolate.

Research on glycopyrrolate has been ongoing for several decades. Scientists have investigated its pharmacological properties, therapeutic applications, and potential benefits in various diseases. One area of focus is its use in COPD, where glycopyrrolate helps to relax airway muscles and improve airflow. Additionally, research is exploring glycopyrrolate's potential for treating other conditions such as Parkinson's disease and post-operative ileus.

Glycopyrrolate's synthesis involves multiple steps, starting with the preparation of the precursor molecule, tropine. Tropine is reacted with an appropriate acid chloride to form the glycopyrrolate ester. The final product is then purified and formulated for use in medications.'

Glycopyrrolate: A muscarinic antagonist used as an antispasmodic, in some disorders of the gastrointestinal tract, and to reduce salivation with some anesthetics. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

glycopyrronium bromide : A quaternary ammonium salt composed of 3-{[cyclopentyl(hydroxy)phenylacetyl]oxy}-1,1-dimethylpyrrolidin-1-ium and bromide ions in a 1:1 ratio. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID11693
CHEMBL ID1201027
CHEBI ID90972
SCHEMBL ID41436
MeSH IDM0009495

Synonyms (138)

Synonym
ahr 504
robinul forte
1-methyl-3-pyrrolidyl alpha-phenylcyclopentaneglycolate methobromide
3-hydroxy-1,1-dimethylpyrrolidinium bromide alpha-cyclopentylmandelate
glycopyrrolate bromide
einecs 209-887-0
glycopyrronii bromidum
pyrrolidinium, 1,1-dimethyl-3-hydroxy-, bromide, alpha-cyclopentylmandelate
bromure de glycopyrronium [inn-french]
pyrrolidinium, 3-hydroxy-1,1-dimethyl-, bromide, alpha-cyclopentylmandelate
bromuro de glicopirronio [inn-spanish]
1,1-dimethyl-3-hydroxypyrrolidinium bromide alpha-cyclopentylmandelate
nsc 251251
glycopyrronii bromidum [inn-latin]
nsc 250836
nsc 251252
HMS3393P12
org-nc-45
cas-596-51-0
tarodyl
asecryl
ahr-504
robinal
glycopyrronium bromide
robinul
596-51-0
gastrodyn
nsc251251
nsc251252
nsc250836
.beta.-1-methyl-3-pyrrolidyl-.alpha.-cyclopentylmandelate methobromide
nodapton
glycopyrrolate
robanul
tarodyn
nva-237
MLS001424112
pt-001
smr000469282
cuvposa
seebri breezhaler
ad-237
chf-5992
3-hydroxy-1,1-dimethylpyrrolidinium bromide .alpha.-cyclopentylmandelate
nsc-250836
pyrrolidinium,1-dimethyl-, bromide
1,1-dimethyl-3-hydroxypyrrolidinium bromide .alpha.-cyclopentylmandelate
mandelic acid, ester with 3-hydroxy-1,1-dimethylpyrrolidinium bromide
3-hydroxy-1,1-dimethylpyrrolidinium bromide-.alpha.-cyclopentylmandelate
pyrrolidinium,1-dimethyl-, bromide, .alpha.-cyclopentylmandelate
wln: t5ktj a1 a1 covxqr&- al5tj &q &e
1-methyl-3-pyrrolidinyl .alpha.-phenylcyclopentaneglycolate methobromide
nsc-251252
nsc-251251
glycopyrrolate (usp)
cuvposa (tn)
glycopyrronium bromide (jan/inn)
D00540
robinul (tn)
seebri breezhaler (tn)
MLS002222301
HMS2051P12
HMS2094A05
(1,1-dimethylpyrrolidin-1-ium-3-yl) 2-cyclopentyl-2-hydroxy-2-phenylacetate bromide
pt001
CHEMBL1201027
nva237
chf-5259
chf5259
glycopyrrone bromide
glycopyrronium (as bromide)
glycopyrrolate, erythro-
HMS1570E14
A832400
3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidin-1-ium bromide
NCGC00179456-02
HMS2097E14
HMS3259P04
nva 237
dtxsid6023109 ,
tox21_113144
dtxcid103109
tox21_113145
nsc759238
pharmakon1600-01505753
nsc-759238
HMS2235F12
S4660
AKOS015962136
CCG-101030
glycopyrrolate [usan:usp]
seebri
copyrrolate
lonhala magnair
bromuro de glicopirronio
bromure de glycopyrronium
seebri neohaler
FT-0626787
HMS3369F10
CCG-213543
HY-17465
CS-1763
NC00694
NC00280
SCHEMBL41436
NCGC00179456-04
tox21_113144_1
3-{[cyclopentyl(hydroxy)phenylacetyl]oxy}-1,1-dimethylpyrrolidin-1-ium bromide
CHEBI:90972
VPNYRYCIDCJBOM-UHFFFAOYSA-M
AC-23382
3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidinium bromide
G0392
mfcd00072137
SR-01000763650-3
sr-01000763650
glycopyrrolate, united states pharmacopeia (usp) reference standard
glycopyrronium for peak identification, european pharmacopoeia (ep) reference standard
glycopyrronium impurity n, european pharmacopoeia (ep) reference standard
glycopyrronium bromide, european pharmacopoeia (ep) reference standard
glycopyrrolate, >=98% (hplc)
HMS3714E14
BCP07110
Q27162963
glycopyrronium bromide ,(s)
AMY22352
glycopyrrolate erythro isomer (ss-isomer)
BCP33298
HMS3885P14
glycopyrronium (bromide);glycopyrrolate (bromide)
(2s,3's)-glycopyrrolate
pyrrolidinium, 3-[(cyclopentylhydroxyphenylacetyl)oxy]-1,1-dimethyl-,bromide
EX-A4155
(1,1-dimethylpyrrolidin-1-ium-3-yl) 2-cyclopentyl-2-hydroxy-2-phenylacetate;bromide
EN300-7405787
3-[(2-cyclopentyl-2-hydroxy-2-phenylacetyl)oxy]-1,1-dimethylpyrrolidin-1-ium bromide
pyrrolidinium, 3-[(cyclopentylhydroxyphenylacetyl)oxy]-1,1-dimethyl-, bromide, [s-(r*,s*)]-
3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidin-1-iumbromide

Research Excerpts

Overview

Glycopyrrolate is an antimuscarinic agent that can be used preoperatively to inhibit drooling and excessive secretions of the respiratory tract. It is a cost-effective, painless second-line therapy for children and adolescents with primary focal hyperhidrosis.

ExcerptReferenceRelevance
"Glycopyrrolate/eFlow® is an investigational drug-device combination of the LAMA glycopyrrolate administered by an eFlow® Closed System (eFlow® CS) nebulizer."( Dose selection for glycopyrrolate/eFlow
Donohue, JF; Goodin, T; Tosiello, R; Wheeler, A, 2017
)
1.5
"Glycopyrrolate (GLY) is an antimuscarinic agent that is used in humans and domestic animals primarily to reduce respiratory tract secretions during anesthesia and to reverse intra-operative bradycardia. "( Pharmacokinetics and pharmacodynamics of glycopyrrolate following a continuous-rate infusion in the horse.
Hochhaus, G; Kandala, B; Rumpler, MJ; Sams, RA; Vickroy, TW, 2014
)
2.11
"Glycopyrrolate is an antimuscarinic agent that can be used preoperatively to inhibit drooling and excessive secretions of the respiratory tract. "( Glycopyrrolate for treatment of clozapine-induced sialorrhea in adults.
Blissit, KT; Latham, C; Pacheco-Perez, J; Tillery, E, 2014
)
3.29
"Glycopyrrolate seemed to be a tolerable anticholinergic agent in the treatment of clozapine-associated sialorrhea."( The Effect of Glycopyrrolate on Nocturnal Sialorrhea in Patients Using Clozapine: A Randomized, Crossover, Double-Blind, Placebo-Controlled Trial.
Cahn, W; Colen-de Koning, JC; Doodeman, HJ; Egberts, TC; Heerdink, ER; Man, WH; Schulte, PF; van Haelst, IM; Wilting, I, 2017
)
1.54
"Oral glycopyrrolate is a cost-effective, painless second-line therapy for children and adolescents with primary focal hyperhidrosis that impacts their quality of life."( Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis.
Chamlin, SL; Mancini, AJ; Paller, AS; Shah, PR; Silverio, AM; Wagner, A, 2012
)
1.41
"Glycopyrrolate is a peripheral anti-muscarinic drug that has been studied in comparison to atropine for many clinical indications, while scopolamine is an anti-muscarinic drug with both peripheral and central effects."( Adverse reaction to atropine and the treatment of organophosphate intoxication.
Hourvitz, A; Luria, S; Robenshtok, E; Tashma, Z, 2002
)
1.04
"Glycopyrrolate is a quaternary ammonium compound with indications for use similar to those for atropine. "( [Glycopyrrolate (Robinul), a new anticholinergic substance].
Cozanitis, DA; Krieg, N, 1983
)
2.62
"Glycopyrrolate is an effective anticholinergic agent in rabbits and rodents and more useful as a preanesthetic agent than atropine sulfate in these animals."( The parasympatholytic effects of atropine sulfate and glycopyrrolate in rats and rabbits.
Cox, AK; Morck, DW; Olson, ME; Vizzutti, D, 1994
)
1.26
"Glycopyrrolate is an anticholinergic agent used to dry oral secretions and has been advocated for routine use with transesophageal echocardiography (TEE). "( A double-blind trial of glycopyrrolate for transesophageal echocardiography.
DiLucente, L; Gorcsan, J; Katz, WE; Thornton, JK; Ziady, GM,
)
1.88
"Glycopyrrolate is an anti-muscarinic agent that can be applied topically and is efficacious in gustatory sweating occurring in other conditions."( A randomised controlled trial of topical glycopyrrolate, the first specific treatment for diabetic gustatory sweating.
Abbott, CA; Boulton, AJ; Hollis, S; Shaw, JE; Tindle, K, 1997
)
1.28
"Glycopyrrolate is a quaternary ammonium compound."( Oral glycopyrrolate alleviates drooling in a patient with tongue cancer.
Olsen, AK; Sjøgren, P, 1999
)
1.54
"Glycopyrrolate is a quaternary anticholinergic drug. "( Design, synthesis, and pharmacological evaluation of soft glycopyrrolate and its analog.
Bodor, N; Huang, F; Ji, F; Juhasz, A; Wu, W, 2000
)
1.99
"Glycopyrrolate (Robinul) is a quaternary ammonium salt which serves as a respiratory enhancing drug. "( Solid-phase extraction techniques for the determination of glycopyrrolate from equine urine by liquid chromatography-tandem mass spectrometry and gas chromatography-mass spectrometry.
Beaumier, P; Firby, P; Leavitt, RK; Matassa, LC; Woodard, D, 1992
)
1.97
"Glycopyrrolate is a quaternary ammonium anticholinergic compound that is poorly absorbed from mucus membranes, thus reducing anticholinergic side effects."( Twelve-hour bronchodilation in asthma with a single aerosol dose of the anticholinergic compound glycopyrrolate.
Bush, RK; Busse, WW; Chervinsky, P; Schroeckenstein, DC, 1988
)
1.21
"Glycopyrrolate is an anticholinergic agent lacking central nervous system effects."( Effects of atropine and glycopyrrolate on cognitive function following anaesthesia and electroconvulsive therapy (ECT).
Halsall, PJ; Kelway, B; Simpson, KH; Smith, RJ, 1986
)
1.3

Effects

Glycopyrrolate has been treated to induce reversible hyposalivation for accelerating caries progression. The drug is superior to atropine with respect to reduction of salivation and stability of cardiac rate and rhythm.

ExcerptReferenceRelevance
"Glycopyrrolate has a slow and erratic absorption from the gastrointestinal system, but even low plasma levels are associated with a distinct and long-lasting antisialogic effect."( Oral glycopyrrolate alleviates drooling in a patient with tongue cancer.
Olsen, AK; Sjøgren, P, 1999
)
1.54
"Glycopyrrolate has been treated to induce reversible hyposalivation for accelerating caries progression."( Novel strategy for dental caries by physiologic dentin regeneration with CPNE7 peptide.
Gug, HR; Jang, JY; Lee, DS; Lee, JH; Park, JC; Park, SJ; Park, YH; Shon, WJ, 2022
)
1.44
"Glycopyrrolate has been successfully used to treat other types of hyperhidrosis."( A medical alternative to the treatment of compensatory sweating.
Callejas, MA; Cladellas, E; Grimalt, R,
)
0.85
"As glycopyrrolate has been reported superior to atropine with respect to reduction of salivation, stability of cardiac rate and rhythm, and recovery, a comparison of these properties of the two drugs and placebo was made in 45 patients undergoing direct laryngoscopy and 45 patients undergoing bronchoscopy, in most cases followed by mediastinoscopy. "( Glycopyrrolate vs. atropine during anaesthesia for laryngoscopy and bronchoscopy.
Grønnebech, H; Johansson, G; Smedebøl, M; Valentin, N, 1993
)
2.35
"Glycopyrrolate solution has the potential to deliver an ocular anticholinergic effect without causing associated central anticholinergic hazards."( The mydriatic effect of topical glycopyrrolate.
Haas, K; Lazar, M; Rothman, S; Varssano, D, 1996
)
2.02
"Glycopyrrolate has a slow and erratic absorption from the gastrointestinal system, but even low plasma levels are associated with a distinct and long-lasting antisialogic effect."( Oral glycopyrrolate alleviates drooling in a patient with tongue cancer.
Olsen, AK; Sjøgren, P, 1999
)
1.54
"Glycopyrrolate has gained popularity and was the most used drug."( Anticholinergic premedication in Finland 1988.
Kanto, J; Kentala, E; Salonen, M, 1990
)
1
"Glycopyrrolate has advantages over atropine as far as the induction of anaesthesia for microlaryngoscopic interventions is concerned."( [Effect of glycopyrrolate and atropine on the behavior of heart rate and pH value of gastric juice during microlaryngoscopies].
Behne, M; Lischke, V; Mickel, A, 1988
)
1.39

Actions

Glycopyrrolate blocked the increase in SDRRI and blunted spectral power at 0.15 Hz. It decreased lower oesophageal sphincter pressure by 0.88 kPa (p less than 0.005)

ExcerptReferenceRelevance
"Glycopyrrolate blocked the increase in SDRRI (P < 0.001) and blunted spectral power at 0.15 Hz (P < 0.05)."( Vagal modulation of heart rate variability during atrial fibrillation in pigs.
Hamdan, MH; Kneip, CF; Mallet, RT; Smith, ML; Williams, AG, 2010
)
1.08
"Glycopyrrolate decreased lower oesophageal sphincter pressure by 0.88 kPa (p less than 0.005)."( The effect of glycopyrrolate (Robinul) on the lower oesophageal sphincter.
Brock-Utne, JG; Dimopoulos, GE; Downing, JW; Moshal, MG; Rubin, J; Welman, S, 1978
)
1.34

Treatment

Treatment with glycopyrrolate did not change pupil diameter or IOP from baseline, nor were there differences between glycopYRrolate and saline-treated (control) dogs. Glycopyrrollate successfully treated intraoperative penile erection.

ExcerptReferenceRelevance
"Glycopyrrolate has been treated to induce reversible hyposalivation for accelerating caries progression."( Novel strategy for dental caries by physiologic dentin regeneration with CPNE7 peptide.
Gug, HR; Jang, JY; Lee, DS; Lee, JH; Park, JC; Park, SJ; Park, YH; Shon, WJ, 2022
)
1.44
"Glycopyrrolate successfully treated intraoperative penile erection. "( Use of glycopyrrolate to treat intraoperative penile erection. Case report and review of the literature.
Sang, CN; Valley, MA,
)
2.03
"Treatment with glycopyrrolate resulted in significant improvements in all lung function measures, independent of smoking status. "( Effect of smoking status on lung function, patient-reported outcomes, and safety among COPD patients treated with glycopyrrolate inhalation powder: pooled analysis of GEM1 and GEM2 studies.
Bowling, A; Goodin, T; Ozol-Godfrey, A; Price, B; Sanjar, S; Sharma, S; Tashkin, DP, 2019
)
1.08
"Treatment with glycopyrrolate did not change pupil diameter or IOP from baseline, nor were there differences between glycopyrrolate and saline-treated (control) dogs."( Parenteral anticholinergics in dogs with normal and elevated intraocular pressure.
Bellay, Y; Brunson, DB; Frischmeyer, KJ; Miller, PE; Smedes, SL,
)
0.47

Toxicity

Glycopyrrolate is superior to atropine in ameliorating the adverse effects of imidocarb. Respiratory arrest is an uncommon side effect with very few published reports.

ExcerptReferenceRelevance
"Two recent studies have identified copious secretions as an independent risk factor for perioperative adverse events in children who present for elective surgery in the presence of an upper respiratory tract infection (URI)."( Glycopyrrolate does not reduce the incidence of perioperative adverse events in children with upper respiratory tract infections.
Burke, C; Chiravuri, D; Malviya, S; Tait, AR; Voepel-Lewis, T; Wagner, D, 2007
)
1.78
" NVA237 was generally well tolerated and associated with a frequency and distribution of adverse events similar to placebo."( Safety and tolerability of NVA237, a once-daily long-acting muscarinic antagonist, in COPD patients.
Cheung, D; Galdiz, JB; Güçlü, SZ; Henley, M; Mizutani, G; Overend, T; Spangenthal, S; Verkindre, C; Vogelmeier, C; Zeldin, RK, 2010
)
0.36
" Once-daily QVA149 was well tolerated in COPD patients with a cardiovascular safety profile and overall adverse event rates similar to placebo."( Cardiovascular safety of QVA149, a combination of Indacaterol and NVA237, in COPD patients.
Dolker, M; Fabbri, LM; Horton, R; Martin, C; Overend, T; Van de Maele, B, 2010
)
0.36
" NVA237 was well tolerated and had an acceptable safety profile, with a low frequency of cardiac and typical antimuscarinic adverse effects."( Efficacy and safety of once-daily NVA237 in patients with moderate-to-severe COPD: the GLOW1 trial.
Banerji, D; D'Urzo, A; Ferguson, GT; Hirata, K; Horton, R; Lu, Y; Martin, C; Overend, T; van Noord, JA, 2011
)
0.37
"Once-daily NVA237 was safe and well tolerated and provided rapid, sustained improvements in lung function, improvements in dyspnoea, and health-related quality of life, and reduced the risk of exacerbations and the use of rescue medication."( Efficacy and safety of once-daily NVA237 in patients with moderate-to-severe COPD: the GLOW1 trial.
Banerji, D; D'Urzo, A; Ferguson, GT; Hirata, K; Horton, R; Lu, Y; Martin, C; Overend, T; van Noord, JA, 2011
)
0.37
" Atropine and glycopyrrolate are anticholinergics that could reduce the adverse effects of imidocarb."( Comparison of glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses.
Donnellan, CM; Guthrie, AJ; Nurton, JP; Page, PC; van den Berg, JS, 2013
)
1.11
"To compare glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses and to determine the effect of combinations of these drugs on the gastrointestinal tract."( Comparison of glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses.
Donnellan, CM; Guthrie, AJ; Nurton, JP; Page, PC; van den Berg, JS, 2013
)
1.14
"Results of this study suggest that glycopyrrolate is superior to atropine in ameliorating the adverse effects of imidocarb."( Comparison of glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses.
Donnellan, CM; Guthrie, AJ; Nurton, JP; Page, PC; van den Berg, JS, 2013
)
1.03
"Glycopyrrolate could be administered with imidocarb in horses with piroplasmosis to reduce the adverse effects of imidocarb."( Comparison of glycopyrrolate and atropine in ameliorating the adverse effects of imidocarb dipropionate in horses.
Donnellan, CM; Guthrie, AJ; Nurton, JP; Page, PC; van den Berg, JS, 2013
)
2.19
" Primary endpoint was safety and tolerability for treatment-emergent adverse events (AEs)."( Safety and efficacy of dual bronchodilation with QVA149 in COPD patients: the ENLIGHTEN study.
Alagappan, VK; Banerji, D; Chapman, KR; Chen, H; Dahl, R; Kho, P; Mehta, R; Rudolf, M, 2013
)
0.39
"2% in the IND+GLY group experienced an adverse event, with the majority being mild-to-moderate in severity."( Efficacy and safety of QVA149 compared to the concurrent administration of its monocomponents indacaterol and glycopyrronium: the BEACON study.
Alagappan, VK; Banerji, D; Chen, H; Dahl, R; Jadayel, D, 2013
)
0.39
" Overall incidence of adverse events (including COPD exacerbations) was 55·4% (143 of 258) for the QVA149 group and 60·2% (159 of 264) for the SFC group."( Efficacy and safety of once-daily QVA149 compared with twice-daily salmeterol-fluticasone in patients with chronic obstructive pulmonary disease (ILLUMINATE): a randomised, double-blind, parallel group study.
Alagappan, VK; Banerji, D; Bateman, ED; Chen, H; D'Andrea, P; Pallante, J; Vogelmeier, CF, 2013
)
0.39
" Adverse events were reported by a similar percentage of patients receiving glycopyrronium (40."( A blinded evaluation of the efficacy and safety of glycopyrronium, a once-daily long-acting muscarinic antagonist, versus tiotropium, in patients with COPD: the GLOW5 study.
Bateman, ED; Beeh, KM; Beier, J; Chapman, KR; Chen, H; D'Andrea, P; D'Urzo, A; Henley, M; Nutbrown, R; Overend, T, 2014
)
0.4
" Primary outcomes were trough FEV1, severe adverse events, and serious cardiovascular events."( Efficacy and safety of a fixed-dose combination of indacaterol and Glycopyrronium for the treatment of COPD: a systematic review.
Plaza, V; Rodrigo, GJ, 2014
)
0.4
" There were no deaths or serious adverse events."( Effect of dual bronchodilation with QVA149 on cardiac safety in healthy volunteers.
Brown, M; Drollmann, A; Febbraro, S; Hara, H; Jones, I; Perry, S; Sechaud, R, 2014
)
0.4
" The incidence of adverse events was similar for the two treatment groups."( Efficacy and safety of coadministration of once-daily indacaterol and glycopyrronium versus indacaterol alone in COPD patients: the GLOW6 study.
Aumann, J; Chen, H; Goyal, P; Henley, M; McBryan, D; Vincken, W, 2014
)
0.4
" In the absence of a better alternative, salbutamol, a beta-2 agonist, or ipratropium, an antimuscarinic, are tried first, despite their adverse effects."( Glycopyrronium for inhalation. COPD: another antimuscarinic with cardiac adverse effects that require monitoring.
, 2014
)
0.4
" Each evaluation included weighing sweat and assessing the Hyperhidrosis Disease Severity Scale (HDSS) score and any adverse effects."( Efficacy and safety of topical glycopyrrolate in patients with facial hyperhidrosis: a randomized, multicentre, double-blinded, placebo-controlled, split-face study.
Choi, HG; Hong, CK; Hyun, MY; Kim, BJ; Kim, MN; Lee, Y; Li, K; Park, KY; Seo, SJ; Son, IP, 2015
)
0.7
" No serious adverse events were reported during the course of this study."( Efficacy and safety of topical glycopyrrolate in patients with facial hyperhidrosis: a randomized, multicentre, double-blinded, placebo-controlled, split-face study.
Choi, HG; Hong, CK; Hyun, MY; Kim, BJ; Kim, MN; Lee, Y; Li, K; Park, KY; Seo, SJ; Son, IP, 2015
)
0.7
"Topical glycopyrrolate application appears to be significantly effective and safe in reducing excessive facial perspiration."( Efficacy and safety of topical glycopyrrolate in patients with facial hyperhidrosis: a randomized, multicentre, double-blinded, placebo-controlled, split-face study.
Choi, HG; Hong, CK; Hyun, MY; Kim, BJ; Kim, MN; Lee, Y; Li, K; Park, KY; Seo, SJ; Son, IP, 2015
)
1.14
" All doses were safe and well tolerated in this study; the most frequently reported adverse event was dry mouth (0-14."( Randomized study of the safety, pharmacokinetics, and bronchodilatory efficacy of a proprietary glycopyrronium metered-dose inhaler in study patients with chronic obstructive pulmonary disease.
Darken, P; Fernandez, C; Fischer, T; Fogarty, C; Golden, M; Orevillo, C; Reisner, C; Rennard, S; Rose, ES; Tardie, G, 2014
)
0.4
"This study demonstrated superior bronchodilatory efficacy of GP MDI compared with Placebo MDI at all doses tested, and no serious adverse events were reported."( Randomized study of the safety, pharmacokinetics, and bronchodilatory efficacy of a proprietary glycopyrronium metered-dose inhaler in study patients with chronic obstructive pulmonary disease.
Darken, P; Fernandez, C; Fischer, T; Fogarty, C; Golden, M; Orevillo, C; Reisner, C; Rennard, S; Rose, ES; Tardie, G, 2014
)
0.4
" Overall hazard ratio (HR) was assessed between the active treatments and placebo and in various subgroups related to severity of airways obstruction, inhaled corticosteroid use, cardiovascular risk factors, sex, age and body mass index for death, serious cases of cardio- and cerebrovascular (CCV) events, major adverse cardiovascular events (MACEs), pneumonia, COPD exacerbations requiring hospitalisation or atrial flutter/fibrillation (AF/F)."( Pooled safety analysis of the fixed-dose combination of indacaterol and glycopyrronium (QVA149), its monocomponents, and tiotropium versus placebo in COPD patients.
Banerji, D; Buhl, R; Chen, H; D'Andrea, P; Dahl, R; Fogel, R; Schubert-Tennigkeit, A; Wedzicha, JA, 2014
)
0.4
"All treatments were well tolerated with similar adverse event rates reported with placebo and at all doses."( Efficacy and safety of nebulized glycopyrrolate for administration using a high efficiency nebulizer in patients with chronic obstructive pulmonary disease.
Barnes, PJ; Jones, CR; Leaker, BR; Singh, D; Tutuncu, A, 2015
)
0.7
" Respiratory arrest is an uncommon side effect of glycopyrrolate with very few published reports."( Glycopyrrolate-induced respiratory arrest: an unusual side effect.
D'souza, S; Gowler, V, 2015
)
2.11
" Overall incidence of adverse events (glycopyrronium 43."( Efficacy and safety of once-daily glycopyrronium in predominantly Chinese patients with moderate-to-severe chronic obstructive pulmonary disease: the GLOW7 study.
Bai, L; D'Andrea, P; Firth, R; Huang, Y; Humphries, M; Kho, P; Li, L; Sun, T; Wang, C; Wang, Q, 2015
)
0.42
" The incidence of adverse events was comparable between both treatments (QVA149=43."( Efficacy and safety of once-daily QVA149 compared with the free combination of once-daily tiotropium plus twice-daily formoterol in patients with moderate-to-severe COPD (QUANTIFY): a randomised, non-inferiority study.
Buhl, R; Foerster, K; Gessner, C; Hiltl, S; Korn, S; Schuermann, W; Sieder, C, 2015
)
0.42
" Although this class of compounds is generally considered to be safe and well tolerated in COPD patients the cardiovascular safety of tiotropium has recently been questioned."( Comparing the cardiovascular therapeutic indices of glycopyrronium and tiotropium in an integrated rat pharmacokinetic, pharmacodynamic and safety model.
Charlton, SJ; Collingwood, S; Ethell, BT; Kent, TC; Sykes, DA; Trifilieff, A; Watson, KJ, 2015
)
0.42
" In most clinical trials the incidence of cardiovascular adverse events was similar in active treatment and placebo groups, especially in patients with previous cardiovascular diseases."( [Are there cardiovascular adverse effects of inhaled anticholinergics?].
Nagy, LB, 2015
)
0.42
"The overall incidence of adverse events and deaths was similar across groups, while the incidence of serious adverse events was numerically higher in placebo."( Safety of inhaled glycopyrronium in patients with COPD: a comprehensive analysis of clinical studies and post-marketing data.
Altman, P; Chapman, KR; D'Andrea, P; D'Urzo, AD; Decramer, M; DiGiovanni, R; Goyal, P; Hu, H; Kerwin, EM, 2015
)
0.42
" PSX1002-GB was well tolerated with similar adverse event rates reported compared to placebo."( Bronchodilator effects, pharmacokinetics and safety of PSX1002-GB, a novel glycopyrronium bromide formulation, in COPD patients; a randomised crossover study.
Buck, H; Down, G; O'Connor, G; Ravi, A; Reid, F; Singh, D, 2016
)
0.43
" The primary objective was to assess the safety and tolerability in terms of adverse event (AE) reporting rates over 52 weeks."( Long-term safety of glycopyrrolate: A randomized study in patients with moderate-to-severe COPD (GEM3).
Banerjee, R; D'Andrea, P; Eckert, JH; Gifford, AH; Jessop, N; Mahler, DA; Mota, F; Satti, A, 2016
)
0.76
" The incidence of major adverse cardiovascular events was low and comparable between the groups."( Long-term safety of glycopyrrolate: A randomized study in patients with moderate-to-severe COPD (GEM3).
Banerjee, R; D'Andrea, P; Eckert, JH; Gifford, AH; Jessop, N; Mahler, DA; Mota, F; Satti, A, 2016
)
0.76
"Significant improvement in lung function, dyspnea, COPD symptoms, health status, and rescue medication use suggests that glycopyrrolate is a safe and effective treatment option as maintenance bronchodilator in patients with stable, symptomatic COPD with moderate-to-severe airflow limitation."( Efficacy and safety of twice-daily glycopyrrolate in patients with stable, symptomatic COPD with moderate-to-severe airflow limitation: the GEM1 study.
D'Andrea, P; Eckert, JH; Feldman, G; Henley, M; LaForce, C; Patalano, F; Spangenthal, S, 2016
)
0.92
"Drawing up atropine or glycopyrrolate at the beginning of the operating list and use within 24 hours if needed are a safe practice and do not pose infection hazard."( Atropine and glycopyrrolate do not support bacterial growth-safety and economic considerations.
Batai, I; Batai, IZ; Ittzes, B; Kerenyi, M; Weiling, Z, 2016
)
1.11
" It also demonstrates a rare drug adverse effect with successful treatment."( Glycopyrrolate-induced craniofacial compensatory hyperhidrosis successfully treated with oxybutynin: report of a novel adverse effect and subsequent successful treatment.
Fischer, R; Liu, D; Prouty, ME, 2016
)
1.88
" Incidences of adverse events, serious adverse events and major adverse cardiovascular events were similar across treatment groups with no unexpected safety findings."( Long-term safety and efficacy of glycopyrrolate/formoterol metered dose inhaler using novel Co-Suspension™ Delivery Technology in patients with chronic obstructive pulmonary disease.
Denenberg, M; Donohue, JF; Hanania, NA; Kerwin, EM; Maes, A; O'Donnell, DE; Orevillo, C; Quinn, D; Reisner, C; Siddiqui, S; Tashkin, DP, 2017
)
0.74
" Neostigmine has good efficacy in the decompression of pseudo-obstruction but is hindered by its wide side effect profile."( Neostigmine and glycopyrronium: a potential safe alternative for patients with pseudo-obstruction without access to conventional methods of decompression.
Adiamah, A; Ho, A; Johnson, S; Orbell, J, 2017
)
0.46
" Primary endpoints were the incidence of treatment-emergent adverse events (TEAEs), serious TEAEs, and discontinuations due to TEAEs."( Long-term safety of glycopyrrolate/eFlow
Ferguson, GT; Goodin, T; Kerwin, E; Tosiello, R; Wheeler, A, 2017
)
0.78
"Treatment with nebulized glycopyrrolate was well tolerated over 48 weeks with the most common adverse events being COPD worsening and cough."( Long-term safety of glycopyrrolate/eFlow
Ferguson, GT; Goodin, T; Kerwin, E; Tosiello, R; Wheeler, A, 2017
)
1.08
" The question if long-acting beta-agonist and long-acting muscarinic antagonist could be associated with the increased prevalence of CV-related adverse effects has puzzled, particularly in the past, specialists involved in the management of respiratory diseases."( Combination Therapy of Inhaled Indacaterol/Glycopyrronium for Chronic Obstructive Pulmonary Disease in the Very Elderly: Is It Safe? An Electrocardiographic Evaluation.
Bernardi, B; Bordoni, V; Borioni, E; Cesari, V; Cocci, G; Francioso, A; Giordano, P; Giulietti, F; Iacoacci, C; Landi, L; Lombardi, FE; Rosettani, G; Sarzani, R; Spannella, F,
)
0.13
" Safety assessments included monitoring for adverse events (AEs)."( Safety and pharmacokinetics of budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) in healthy adult subjects of Japanese descent.
DePetrillo, P; Dorinsky, P; Maes, A; Reisner, C; Siddiqui, S, 2018
)
0.48
" All GP MDI doses were well tolerated with no evidence of a dose-related effect on adverse events."( Efficacy, safety, and dose response of glycopyrronium administered by metered dose inhaler using co-suspension delivery technology in subjects with intermittent or mild-to-moderate persistent asthma: A randomized controlled trial.
Darken, P; Dorinsky, P; Duncan, EA; Kerwin, E; Nyberg, J; Reisner, C; Sher, L; Siddiqui, S; Wachtel, A, 2018
)
0.48
" Treatment-emergent adverse events were similar between subgroups, and most were mild, transient, and infrequently led to discontinuation."( Glycopyrronium tosylate in pediatric primary axillary hyperhidrosis: Post hoc analysis of efficacy and safety findings by age from two phase three randomized controlled trials.
Drew, J; Forsha, DW; Glaser, DA; Gopalan, R; Green, L; Hebert, AA; Pariser, DM; Werschler, WP, 2019
)
0.51
" GT was well tolerated, and treatment-emergent adverse events were qualitatively similar between subgroups and consistent with other anticholinergics."( Glycopyrronium tosylate in pediatric primary axillary hyperhidrosis: Post hoc analysis of efficacy and safety findings by age from two phase three randomized controlled trials.
Drew, J; Forsha, DW; Glaser, DA; Gopalan, R; Green, L; Hebert, AA; Pariser, DM; Werschler, WP, 2019
)
0.51
" Treatment-emergent adverse events and local skin reactions were assessed."( A 44-Week Open-Label Study Evaluating Safety and Efficacy of Topical Glycopyrronium Tosylate in Patients with Primary Axillary Hyperhidrosis.
Drew, J; Glaser, DA; Green, L; Hebert, AA; Mamelok, RD; Nast, A; Pariser, DM; Quiring, J; Werschler, WP, 2019
)
0.51
" Most patients experiencing treatment-emergent adverse events had mild or moderate events (> 90%)."( A 44-Week Open-Label Study Evaluating Safety and Efficacy of Topical Glycopyrronium Tosylate in Patients with Primary Axillary Hyperhidrosis.
Drew, J; Glaser, DA; Green, L; Hebert, AA; Mamelok, RD; Nast, A; Pariser, DM; Quiring, J; Werschler, WP, 2019
)
0.51
" Adverse events were also assessed."( Bone and ocular safety of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler in COPD: a 52-week randomized study.
DeAngelis, K; Dorinsky, P; Ferguson, GT; Kerwin, EM; Mo, M, 2019
)
0.79
" The incidence of treatment-emergent adverse events (TEAEs)  was generally similar among groups."( Bone and ocular safety of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler in COPD: a 52-week randomized study.
DeAngelis, K; Dorinsky, P; Ferguson, GT; Kerwin, EM; Mo, M, 2019
)
0.79
" All the treatment-emergent adverse events (TEAEs) were mild and no severe TEAE was reported."( Pharmacokinetics, pharmacodynamics and safety of a novel extrafine BDP/FF/GB combination delivered via metered-dose inhaler in healthy Chinese subjects.
Hu, C; Luo, Z; Miao, J; Shu, S; Wang, Y; Zhu, X, 2020
)
0.56
" BDP/FF/GB pMDI was safe and well tolerated in healthy Chinese subjects."( Pharmacokinetics, pharmacodynamics and safety of a novel extrafine BDP/FF/GB combination delivered via metered-dose inhaler in healthy Chinese subjects.
Hu, C; Luo, Z; Miao, J; Shu, S; Wang, Y; Zhu, X, 2020
)
0.56
" Safety was evaluated over 52 weeks via adverse event (AE) monitoring, electrocardiograms, clinical laboratory testing, and vital sign measurements."( Long-Term Safety and Efficacy of Budesonide/Glycopyrrolate/Formoterol Fumarate Metered Dose Inhaler Formulated Using Co-Suspension Delivery Technology in Japanese Patients with COPD.
Aurivillius, M; Ballal, S; Bourne, E; DeAngelis, K; Dorinsky, P; Ferguson, GT; Fukushima, Y; Hataji, O; Hayashi, N; Ichinose, M; Inoue, Y; Okada, H; Rabe, KF; Reisner, C; Takikawa, M, 2019
)
0.78
" Most treatment-related adverse events were mild or moderate."( Efficacy and safety of topical sofpironium bromide gel for the treatment of axillary hyperhidrosis: A phase II, randomized, controlled, double-blinded trial.
Baumann, L; Bhatia, N; Chadha, D; Cohen, J; DuBois, J; Green, L; Kirsch, B; Liu, PY; Pariser, D; Smith, S; Walker, P, 2020
)
0.56
" Safety assessments included treatment-emergent adverse events (TEAEs) and local skin reactions (LSRs)."( Long-term efficacy and safety of topical glycopyrronium tosylate for the treatment of primary axillary hyperhidrosis: Post hoc pediatric subgroup analysis from a 44-week open-label extension study.
Cather, J; Drew, J; Glaser, DA; Gopalan, R; Green, L; Hebert, AA; Hull, C; Pariser, DM, 2020
)
0.56
" Treatment was safe: most treatment-emergent adverse effects were mild or moderate, and transient."( A glycopyrronium bromide 1% cream for topical treatment of primary axillary hyperhidrosis: efficacy and safety results from a phase IIIa randomized controlled trial.
Abels, C; Heimstaedt-Muskett, S; Jourdan, C; Kilic, A; Knie, U; Masur, C; Reich, H; Schramm, K; Soeberdt, M; Szeimies, RM, 2021
)
0.62
" Being familiar with new medications and their side effect profiles can prevent unnecessary or harmful interventions."( A new medication, a new toxidrome - A case report of anticholinergic wipe toxicity due to improper medication use.
Michael, T; Paul, C, 2021
)
0.62
" Specifically, this study assessed the impact of sugammadex on cardiac adverse events (AEs) and other prespecified AEs of clinical interest."( A randomized trial evaluating the safety profile of sugammadex in high surgical risk ASA physical class 3 or 4 participants.
Blobner, M; Broussard, DM; Herring, WJ; Lin, L; Lombard, JF; Lutkiewicz, J; Mukai, Y; Wang, A; Watkins, M, 2021
)
0.62
"Pediatric sedation is a clinical activity with potential for serious but rare airway adverse events, particularly laryngospasm."( Anticholinergics and serious adverse events in pediatric procedural sedation: A report of the pediatric sedation research consortiums.
Boriosi, JP; Ferrazzano, P; Hollman, GA; Lasarev, MR; Peters, ME, 2022
)
0.72
"The objective of this study is to describe the current practice of anticholinergic use in pediatric sedation and to compare the frequency of serious sedation-related adverse events in patients who received anticholinergics to those who did not."( Anticholinergics and serious adverse events in pediatric procedural sedation: A report of the pediatric sedation research consortiums.
Boriosi, JP; Ferrazzano, P; Hollman, GA; Lasarev, MR; Peters, ME, 2022
)
0.72
" Patient characteristics, procedure type, sedation provider, sedatives, location of sedation, anticholinergic administered, adverse events, and airway interventions were reported."( Anticholinergics and serious adverse events in pediatric procedural sedation: A report of the pediatric sedation research consortiums.
Boriosi, JP; Ferrazzano, P; Hollman, GA; Lasarev, MR; Peters, ME, 2022
)
0.72
" Use of anticholinergics was more common in patients with well-described risk factors for airway adverse events: active/history of upper respiratory infection, history of reactive airway disease/asthma, and exposure to smoke."( Anticholinergics and serious adverse events in pediatric procedural sedation: A report of the pediatric sedation research consortiums.
Boriosi, JP; Ferrazzano, P; Hollman, GA; Lasarev, MR; Peters, ME, 2022
)
0.72
"In this large Pediatric Sedation Research Consortium study, we found the use of anticholinergic adjuvants independently associated with greater odds of serious adverse events, especially airway adverse events, after adjusting for well-known sedation risk factors using propensity score matching and multivariate analysis."( Anticholinergics and serious adverse events in pediatric procedural sedation: A report of the pediatric sedation research consortiums.
Boriosi, JP; Ferrazzano, P; Hollman, GA; Lasarev, MR; Peters, ME, 2022
)
0.72
" The primary endpoint was incidence and severity of treatment-emergent adverse events (AEs) over 52-weeks."( Long-term safety of once-daily indacaterol acetate/glycopyrronium bromide/mometasone furoate high-dose, and indacaterol acetate/mometasone furoate high-dose, in Japanese patients with inadequately controlled asthma: Results from two open-label, 52-week st
D'Andrea, P; Hosoe, M; Matsuo, K; Nakamura, Y; Pethe, A; Sagara, H; Tanaka, Y; Tanase, AM, 2023
)
0.91
" Safety data, including local skin reactions and other adverse events, were tabulated by cohort."( Open-Label Cohort Study to Evaluate Efficacy and Safety of Application of Glycopyrronium Cloth, 2.4% for Palmar Hyperhidrosis.
Benedict, D; Pariser, D; Rivera, E, 2022
)
0.72
" The most common adverse event was unilateral mydriasis, which presumably occurred from inadvertent introduction of study drug into the eye despite multiple warnings to the subjects to avoid eye contact."( Open-Label Cohort Study to Evaluate Efficacy and Safety of Application of Glycopyrronium Cloth, 2.4% for Palmar Hyperhidrosis.
Benedict, D; Pariser, D; Rivera, E, 2022
)
0.72
" Sugammadex exhibits advantages over indirect reversal agent acetylcholinesterase inhibitor neostigmine with less adverse effects."( Sugammadex reversal of muscle relaxant blockade provided less Post-Anesthesia Care Unit adverse effects than neostigmine/glycopyrrolate.
Chang, HC; Lee, MJ; Lee, SO; Liu, SY; Wong, CS, 2022
)
0.93
" Treatment was safe and locally well-tolerated with only few mild to moderate adverse drug reactions (ADRs)."( Long-term efficacy and safety of 1% glycopyrronium bromide cream in patients with severe primary axillary hyperhidrosis: Results from a Phase 3b trial.
Abels, C; Berger, B; Heimstaedt-Muskett, S; Kilic, A; Litzka, L; Masur, C; Reich, H; Schramm, K; Schulze Zur Wiesche, E; Szeimies, RM, 2023
)
0.91

Pharmacokinetics

The disposition of plasma glycopyrrolate (GLY) is characterized by a three-compartment pharmacokinetic model after a 1-mg bolus intravenous dose to Standardbred horses.

ExcerptReferenceRelevance
"97) micrograms/l and mean Tmax (time to Cmax) of 13."( Radioreceptor assay for pharmacokinetic studies of glycopyrrolate.
Ali-Melkkilä, T; Iisalo, E; Kaila, T; Kanto, J, 1990
)
0.53
"1 min and mean elimination half-life of 75."( Pharmacokinetics of i.m. glycopyrronium.
Ali-Melkkilä, TM; Iisalo, E; Kaila, T; Kanto, J, 1990
)
0.28
"5) ng/ml, a mean time to Cmax (Tmax) of 10."( Pharmacokinetics of glycopyrronium in parturients.
Ali-Melkkilä, T; Iisalo, E; Kaila, T; Kanto, J, 1990
)
0.28
"In the present study, a sensitive and reproducible radioreceptor assay (RRA) was used to evaluate the basic pharmacokinetic properties of glycopyrrolate, a quaternary amine with peripheral antimuscarinic activity."( Glycopyrrolate: pharmacokinetics and some pharmacodynamic findings.
Ali-Melkkilä, T; Kaila, T; Kanto, J, 1989
)
1.92
"Several specific and sensitive new methods for determining atropine and its metabolites in biological fluids have increased the possibility to characterise the pharmacokinetic properties of this antimuscarinic agent."( Pharmacokinetic implications for the clinical use of atropine, scopolamine and glycopyrrolate.
Kanto, J; Klotz, U, 1988
)
0.5
" The only significant difference in the pharmacokinetic parameters was the shortened elimination half-life in patients between 1 and 3 years of age."( Pharmacokinetics of glycopyrrolate in children.
Ali-Melkkilä, T; Iisalo, E; Kaila, T; Kanto, J; Olkkola, KT; Rautakorpi, P,
)
0.45
" The shortened elimination half-life in children between 1 and 3 years of age is of minor clinical importance."( Pharmacokinetics of glycopyrrolate in children.
Ali-Melkkilä, T; Iisalo, E; Kaila, T; Kanto, J; Olkkola, KT; Rautakorpi, P,
)
0.45
"The pharmacokinetics and some pharmacodynamic properties of atropine, glycopyrrolate and scopolamine are reviewed."( Pharmacokinetics and related pharmacodynamics of anticholinergic drugs.
Ali-Melkkilä, T; Iisalo, E; Kanto, J, 1993
)
0.52
" In this study, we used population pharmacokinetic (PK) modelling to provide insights into the impact of the lung PK of glycopyrronium on its systemic PK profile and, in turn, to understand the impact of lung bioavailability and residence time on the choice of dosage regimen."( Determination of the pharmacokinetics of glycopyrronium in the lung using a population pharmacokinetic modelling approach.
Bartels, C; Kaiser, G; Looby, M; Sechaud, R, 2013
)
0.39
" Its extended intrapulmonary residence time also provides pharmacokinetic evidence that glycopyrronium has the profile of a once-daily drug."( Determination of the pharmacokinetics of glycopyrronium in the lung using a population pharmacokinetic modelling approach.
Bartels, C; Kaiser, G; Looby, M; Sechaud, R, 2013
)
0.39
" Although GLY is used routinely in veterinary patients, there is limited information regarding its pharmacokinetic (PK) and pharmacodynamic (PD) properties in domestic animals, and an improved understanding of the plasma concentration-effect relationship in racehorses is warranted."( Pharmacokinetics and pharmacodynamics of glycopyrrolate following a continuous-rate infusion in the horse.
Hochhaus, G; Kandala, B; Rumpler, MJ; Sams, RA; Vickroy, TW, 2014
)
0.67
" The primary pharmacokinetics (PK) parameters were plasma peak concentration (Cmax), AUC up to the last measured concentration (AUClast), and renal clearance (CLr) of glycopyrronium."( Effect of cimetidine, a model drug for inhibition of the organic cation transport (OCT2/MATE1) in the kidney, on the pharmacokinetics of glycopyrronium.
Camenisch, G; Drollmann, A; Dumitras, S; Kaiser, G; Pal, P; Sechaud, R; Vaidyanathan, S, 2013
)
0.39
" Cmax was not affected."( Effect of cimetidine, a model drug for inhibition of the organic cation transport (OCT2/MATE1) in the kidney, on the pharmacokinetics of glycopyrronium.
Camenisch, G; Drollmann, A; Dumitras, S; Kaiser, G; Pal, P; Sechaud, R; Vaidyanathan, S, 2013
)
0.39
"The disposition of plasma glycopyrrolate (GLY) is characterized by a three-compartment pharmacokinetic model after a 1-mg bolus intravenous dose to Standardbred horses."( The pharmacokinetics of glycopyrrolate in Standardbred horses.
Colahan, P; Rumpler, MJ; Sams, RA, 2014
)
1.01
" A population pharmacokinetic (PK) analysis was performed to describe the PK profiles of indacaterol and glycopyrronium following the twice daily (b."( Population pharmacokinetics of IND/GLY (indacaterol/glycopyrronium) in COPD patients.
Bartels, C; Bieth, B; Demin, I; Gautier, A; Graham, G; Sechaud, R; Tillmann, HC, 2016
)
0.43
"This was a Phase I, randomized, double-blind, placebo-controlled, ascending-dose, crossover study to assess the safety and pharmacokinetic profiles of two doses of BGF MDI in healthy adult subjects of Japanese descent (NCT02197975)."( Safety and pharmacokinetics of budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) in healthy adult subjects of Japanese descent.
DePetrillo, P; Dorinsky, P; Maes, A; Reisner, C; Siddiqui, S, 2018
)
0.48
"Twenty subjects were randomized and included in the safety and pharmacokinetic populations; mean age 29."( Safety and pharmacokinetics of budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) in healthy adult subjects of Japanese descent.
DePetrillo, P; Dorinsky, P; Maes, A; Reisner, C; Siddiqui, S, 2018
)
0.48
"This randomized, Phase I, single-dose, four-treatment, four-period, crossover study (NCT02196714) examined the pharmacokinetic (PK) and safety profile of two doses of GFF MDI (28."( Pharmacokinetics and safety of a single dose of the novel LAMA/LABA fixed-dose combination of glycopyrronium/formoterol fumarate dihydrate metered dose inhaler, formulated using co-suspension delivery technology, in Japanese healthy subjects.
DePetrillo, P; Maes, A; Martin, UJ; Miller, J; Reisner, C; Siddiqui, S, 2018
)
0.48
"We conducted two studies to characterize the pharmacokinetic (PK) profile of BGF MDI in patients with COPD: (i) a phase I, open-label, single and chronic (7-day) dosing study (NCT03250182) with one treatment arm (BGF MDI 320/18/9."( Pharmacokinetics of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler formulated using co-suspension delivery technology after single and chronic dosing in patients with COPD.
Darken, P; DeAngelis, K; Dorinsky, P; Dunn, LJ; Gillen, M; Kerwin, EM, 2020
)
0.84
" Limited data on the pharmacokinetic (PK) and pharmacodynamic (PD) properties of BDP/FF/GB fixed-dose combination in healthy subjects was available."( Pharmacokinetics, pharmacodynamics and safety of a novel extrafine BDP/FF/GB combination delivered via metered-dose inhaler in healthy Chinese subjects.
Hu, C; Luo, Z; Miao, J; Shu, S; Wang, Y; Zhu, X, 2020
)
0.56
" Heart rate (HR), QTcF, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated as the surrogate indicators of pharmacodynamic effects."( Pharmacokinetics, pharmacodynamics and safety of a novel extrafine BDP/FF/GB combination delivered via metered-dose inhaler in healthy Chinese subjects.
Hu, C; Luo, Z; Miao, J; Shu, S; Wang, Y; Zhu, X, 2020
)
0.56
" The dose adjusted pharmacokinetic profiles of BDP, beclomethasone-17-monopropionate (B17MP, the most active metabolite of BDP), formoterol and GB were overall similar in therapeutic and supra- therapeutic dose group, showing dose proportional increase of the systemic exposure to BDP, B17MP, formoterol and GB."( Pharmacokinetics, pharmacodynamics and safety of a novel extrafine BDP/FF/GB combination delivered via metered-dose inhaler in healthy Chinese subjects.
Hu, C; Luo, Z; Miao, J; Shu, S; Wang, Y; Zhu, X, 2020
)
0.56
" A physiologically based pharmacokinetic (PBPK) model was developed in patients with COPD with normal renal function and used to predict systemic exposure of glycopyrronium in patients with severe renal impairment."( Physiologically Based Pharmacokinetic Modelling of Glycopyrronium in Patients With Renal Impairment.
Gillen, M; Higashimori, M; Ishikawa, K; Zhou, D, 2021
)
0.62
" There was no clinically relevant pharmacokinetic interaction between IND, GLY and MF when administered as IND/GLY/MF."( Pharmacokinetics of indacaterol, glycopyrronium and mometasone furoate following once-daily inhalation as a combination in healthy subjects.
Abdallah, N; Drollmann, A; Ethell, B; Hahn, M; Heudi, O; Ignatenko, S; Jauernig, J; Last, S; Machineni, S; Radhakrishnan, R; Tillmann, HC; Vaidya, S, 2020
)
0.56
" However, pharmacokinetic (PK) studies of other drugs have shown that ethnic factors (e."( Ethnic pharmacokinetic comparison of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) between Asian and Western healthy subjects.
Assam, PN; Dorinsky, P; Feng, C; Gillen, M; Huang, Y; Su, R, 2020
)
0.81
"Clinical evidence suggests no clinically relevant pharmacokinetic interactions between indacaterol (IND), glycopyrronium (GLY) and mometasone furoate (MF)."( Population Pharmacokinetic Analysis of Indacaterol/Glycopyrronium/Mometasone Furoate After Administration of Combination Therapies Using the Breezhaler
Bartels, C; Jain, M; Tillmann, HC; Vaidya, S; Yu, J, 2021
)
0.62
"The final pharmacokinetic models were two-compartment disposition models with first-order elimination and sequential zero-order/first-order absorption (IND), with bolus administration and first-order elimination (GLY), and with mixed zero-order/first-order absorption and first-order elimination (MF)."( Population Pharmacokinetic Analysis of Indacaterol/Glycopyrronium/Mometasone Furoate After Administration of Combination Therapies Using the Breezhaler
Bartels, C; Jain, M; Tillmann, HC; Vaidya, S; Yu, J, 2021
)
0.62
" The pharmacokinetic profiles of MF were comparable for combination products at corresponding medium- or high-dose inhaled corticosteroids."( Population Pharmacokinetic Analysis of Indacaterol/Glycopyrronium/Mometasone Furoate After Administration of Combination Therapies Using the Breezhaler
Bartels, C; Jain, M; Tillmann, HC; Vaidya, S; Yu, J, 2021
)
0.62

Compound-Compound Interactions

Glycopyrrolate should be used in combination with antacid therapy before obstetric anaesthesia and puerperal tubal ligation because of its prolonged duration of action, effect on gastric secretion and failure to cross placental barrier.

ExcerptReferenceRelevance
" It is suggested that glycopyrrolate should be used in combination with antacid therapy before obstetric anaesthesia and puerperal tubal ligation because of its prolonged duration of action, effect on gastric secretion and failure to cross the placental barrier."( Effects of glycopyrrolate and atropine combined with antacid on gastric acidity.
Roper, RE; Salem, MG, 1981
)
0.97
"No more effective than tiotropium combined with formoterol."( Glycopyrronium + indacaterol. A fixed-dose combination with no advantages in COPD.
, 2014
)
0.4
" The GLISTEN trial compared the efficacy of two long-acting anti-muscarinic antagonists (LAMA), when combined with an inhaled corticosteroid (ICS) and a long-acting β2 agonist (LABA)."( Glycopyrronium once-daily significantly improves lung function and health status when combined with salmeterol/fluticasone in patients with COPD: the GLISTEN study, a randomised controlled trial.
Bremner, P; Chang, CL; Day, P; Frenzel, C; Frith, PA; Kurstjens, N; Ratnavadivel, R; Thompson, PJ, 2015
)
0.42
"This randomised, blinded, placebo-controlled trial in moderate/severe COPD patients compared once-daily glycopyrronium (GLY) 50 µg, once-daily tiotropium (TIO) 18 µg or placebo (PLA), when combined with salmeterol/fluticasone propionate (SAL/FP) 50/500 µg twice daily."( Glycopyrronium once-daily significantly improves lung function and health status when combined with salmeterol/fluticasone in patients with COPD: the GLISTEN study, a randomised controlled trial.
Bremner, P; Chang, CL; Day, P; Frenzel, C; Frith, PA; Kurstjens, N; Ratnavadivel, R; Thompson, PJ, 2015
)
0.42
"Seventy-four patients undergoing TURBT were randomly allocated to receive either glycopyrrolate 10 μg/kg (glycopyrrolate group, n = 37) or atropine 15 μg/kg (atropine group, n = 37) in combination with neostigmine 25 μg/kg at the end of surgery for reversal of neuromuscular blockade."( Effect of glycopyrrolate versus atropine coadministered with neostigmine for reversal of rocuronium on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor: a prospective randomized study.
Kim, HC; Lim, SM; Park, HP; Seo, H, 2015
)
1.05
"This two-period, open-label, crossover study examined the drug-drug interaction of CHF 5993 and cimetidine."( A Two-Period Open-Label, Single-Dose Crossover Study in Healthy Volunteers to Evaluate the Drug-Drug Interaction Between Cimetidine and Inhaled Extrafine CHF 5993.
Acerbi, D; Ciurlia, G; Mariotti, F; Muraro, A; Spaccapelo, L, 2017
)
0.46
"Overall, this study indicates that there is no clinically relevant drug-drug interaction between CHF 5993 and cimetidine."( A Two-Period Open-Label, Single-Dose Crossover Study in Healthy Volunteers to Evaluate the Drug-Drug Interaction Between Cimetidine and Inhaled Extrafine CHF 5993.
Acerbi, D; Ciurlia, G; Mariotti, F; Muraro, A; Spaccapelo, L, 2017
)
0.46
" PROCEDURES In a randomized crossover study, each dog received 5 premedication protocols (medetomidine [10 μg/kg, IV] alone [MED] and in combination with MK-467 at doses of 50 [MMK50], 100 [MMK100], and 150 [MMK150] μg/kg and 15 minutes after glycopyrrolate [10 μg/kg, SC; MGP]), with at least 14 days between treatments."( Cardiovascular effects of premedication with medetomidine alone and in combination with MK-467 or glycopyrrolate in dogs subsequently anesthetized with isoflurane.
Bennett, RC; Kuusela, E; Raekallio, MR; Salla, KM; Scheinin, M; Tuns, CI; Vainio, OM, 2017
)
0.85
"A simple and sensitive analytical method for four isomers of glycopyrrolate in rat plasma was developed using cation-selective exhaustive injection-sweeping cyclodextrin-modified electrokinetic chromatography (CSEI-Sweeping-CDEKC) for online enrichment combined with dispersive micro-solid-phase extraction pretreatment."( Dispersive micro-solid-phase extraction combined with online preconcentration by capillary electrophoresis for the determination of glycopyrrolate stereoisomers in rat plasma.
Chen, D; Liu, Y; Yu, L; Zhang, H, 2018
)
0.93

Bioavailability

Glycopyrrolate is a quaternary ammonium anticholinergic compound that is poorly absorbed from mucus membranes.Oral bioavailability varies widely, with a median of 3.5 micrograms/kg.

ExcerptReferenceRelevance
" or oral atropine administration, typical anticholinergic effects coincide quite well with the absorption rate of the drug, indicating that the premedication should be given about 1 and 2 h before induction of anaesthesia."( Pharmacokinetic implications for the clinical use of atropine, scopolamine and glycopyrrolate.
Kanto, J; Klotz, U, 1988
)
0.5
" Glycopyrrolate is a quaternary ammonium anticholinergic compound that is poorly absorbed from mucus membranes, thus reducing anticholinergic side effects."( Twelve-hour bronchodilation in asthma with a single aerosol dose of the anticholinergic compound glycopyrrolate.
Bush, RK; Busse, WW; Chervinsky, P; Schroeckenstein, DC, 1988
)
1.4
" Because of the quaternary nature, it is poorly absorbed when taken orally and penetrates neither placental nor blood-brain barriers."( [Glycopyrrolate (Robinul), a new anticholinergic substance].
Cozanitis, DA; Krieg, N, 1983
)
1.18
"Based on plasma levels determined with a radioreceptor assay and following a single oral (50 micrograms/kg) and intravenous (5 micrograms/kg) administration of glycopyrrolate in six healthy children operated twice during a several weeks period, a negligible and variable oral bioavailability was found (3."( Pharmacokinetics and oral bioavailability of glycopyrrolate in children.
Ali-Melkkilä, T; Kaila, T; Kanto, J; Manner, T; Olkkola, K; Rautakorpi, P, 1998
)
0.76
" In this study, we used population pharmacokinetic (PK) modelling to provide insights into the impact of the lung PK of glycopyrronium on its systemic PK profile and, in turn, to understand the impact of lung bioavailability and residence time on the choice of dosage regimen."( Determination of the pharmacokinetics of glycopyrronium in the lung using a population pharmacokinetic modelling approach.
Bartels, C; Kaiser, G; Looby, M; Sechaud, R, 2013
)
0.39
"The ATP-binding cassette transporter P-glycoprotein (P-gp) is known to limit both brain penetration and oral bioavailability of many chemotherapy drugs."( A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
Ambudkar, SV; Brimacombe, KR; Chen, L; Gottesman, MM; Guha, R; Hall, MD; Klumpp-Thomas, C; Lee, OW; Lee, TD; Lusvarghi, S; Robey, RW; Shen, M; Tebase, BG, 2019
)
0.51
" genetic factors affecting drug metabolism) can affect the bioavailability of drugs which may impact upon efficacy and safety outcomes."( Ethnic pharmacokinetic comparison of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) between Asian and Western healthy subjects.
Assam, PN; Dorinsky, P; Feng, C; Gillen, M; Huang, Y; Su, R, 2020
)
0.81

Dosage Studied

Glycopyrrolate is emerging as a potential second-line treatment option, but experience with safety, efficacy, and dosing is especially limited in children. The urine method described in this report is simple and efficient and is the first reported method with sufficient sensitivity, accuracy, and precision.

ExcerptRelevanceReference
" The latter dosage of this drug combination thus appears preferable in patients presenting for emergency surgery, if the integrity of the lower oesophageal sphincter is to be maintained during extubation and recovery from general anaesthesia."( Reversal of neuromuscular blockade by glycopyrrolate and neostigmine. A study of the effects on lower oesophageal sphincter tone.
Brock-Utne, JG,
)
0.4
" Furthermore, significant bronchodilation was noted within 30 minutes of dosing and was sustained for at least 12 hours."( Twelve-hour bronchodilation in asthma with a single aerosol dose of the anticholinergic compound glycopyrrolate.
Bush, RK; Busse, WW; Chervinsky, P; Schroeckenstein, DC, 1988
)
0.49
" It was concluded that glycopyrrolate enhanced atracurium-induced neuromuscular blockade in the rat diaphragm preparation, and that this effect should be noted when dosing glycopyrrolate in man."( Glycopyrrolate intensifies neuromuscular blockade produced by atracurium in the rat diaphragm preparation.
Altinel, A; Dark, CH; Jones, CJ; Wali, FA, 1987
)
2.03
" After administration of glycopyrrolate, cardiac performance decreased, but the decrease was not significant when compared with the ventricular performance of the cats after administration of the large dosage of xylazine."( Cardiac performance in cats after administration of xylazine or xylazine and glycopyrrolate: echocardiographic evaluations.
Dunkle, N; Moise, NS; Scarlett-Kranz, J; Short, CE, 1986
)
0.8
" It is suggested that the dosage of anticholinergic agents given with neostigmine could be reduced in elderly patients in comparison to that in younger patients."( Antagonism of neuromuscular block in the elderly. A comparison of atropine and glycopyrronium in a mixture with neostigmine.
Mirakhur, RK, 1985
)
0.27
" After several pilot dose-response studies, we administered 8 mg of the cholinergic agonist arecoline subcutaneously to eight pairs of normal volunteer identical twins and eight bipolar patients currently euthymic and unmedicated."( Behavioral, physiological, and neuroendocrine responses to arecoline in normal twins and "well state" bipolar patients.
Gershon, ES; Gillin, JC; Jimerson, DC; Lawrence, D; Nadi, NS; Nurnberger, JI; Simmons-Alling, S; Sitaram, N; Tamminga, C, 1983
)
0.27
" Glycopyrrolate, being about twice as potent as atropine in the clinical situation, was used in half the dosage of atropine."( A comparison of atropine and glycopyrrolate in anaesthetic practice.
Kongsrud, F; Sponheim, S, 1982
)
1.47
" Glycopyrrolate was administered IV and IM at a dosage of 11 micrograms/kg of body weight, each."( Alterations in the arrhythmogenic dose of epinephrine after xylazine or medetomidine administration in halothane-anesthetized dogs.
Benson, GJ; Lemke, KA; Olson, WA; Thurmon, JC; Tranquilli, WJ, 1993
)
1.2
" Glycopyrrolate was administered IV and IM at a dosage of 11 micrograms/kg of body weight, each."( Alterations in the arrhythmogenic dose of epinephrine after xylazine or medetomidine administration in isoflurane-anesthetized dogs.
Benson, GJ; Lemke, KA; Olson, WA; Thurmon, JC; Tranquilli, WJ, 1993
)
1.2
" One alternative is the combination of glycopyrrolate, alfentanil and suxamethonium described here, although the ideal medication and dosage still remain to be defined."( Physiological changes, plasma beta-endorphin and cortisol responses to tracheal intubation in neonates.
Koivisto, M; Pokela, ML, 1994
)
0.56
"Prospective, open-label study of drug dosage parameters, response to therapy, and side effects."( Glycopyrrolate treatment of chronic drooling.
Blasco, PA; Stansbury, JC, 1996
)
1.74
"001), whereas glycopyrrolate increased peak HR to sea level values, 184 +/- 3 beats/min, confirming adequate dosing with each drug."( Role of the autonomic nervous system in the reduced maximal cardiac output at altitude.
Bogaard, HJ; Hopkins, SR; Niizeki, K; Wagner, PD; Yamaya, Y; Ziegler, MG, 2002
)
0.68
" The urine method described in this report is simple and efficient and is the first reported method with sufficient sensitivity, accuracy, and precision to regulate the use of glycopyrrolate in urine samples collected more than one day after dosing of horses."( Regulatory control of glycopyrrolate in performance horses using validated UHPLC/MS-MS methods.
Colahan, P; Rumpler, MJ; Sams, RA, 2012
)
0.89
" At a mean dosage of 2 mg daily, 90% of patients experienced improvement, which was major in 71% of responders."( Oral glycopyrrolate as second-line treatment for primary pediatric hyperhidrosis.
Chamlin, SL; Mancini, AJ; Paller, AS; Shah, PR; Silverio, AM; Wagner, A, 2012
)
0.89
" All OD and BID dosing regimens produced dose-dependent bronchodilation; at Day 28, increases in mean trough FEV1 versus placebo were statistically significant for all regimens, ranging from 51 mL (glycopyrronium bromide 12."( A novel model-based approach for dose determination of glycopyrronium bromide in COPD.
Alagappan, V; Arievich, H; Banerji, D; Gibbs, M; Looby, M; Overend, T; Renard, D, 2012
)
0.38
" Importantly, OD dosing may confer better patient adherence."( A novel model-based approach for dose determination of glycopyrronium bromide in COPD.
Alagappan, V; Arievich, H; Banerji, D; Gibbs, M; Looby, M; Overend, T; Renard, D, 2012
)
0.38
" In this study, we used population pharmacokinetic (PK) modelling to provide insights into the impact of the lung PK of glycopyrronium on its systemic PK profile and, in turn, to understand the impact of lung bioavailability and residence time on the choice of dosage regimen."( Determination of the pharmacokinetics of glycopyrronium in the lung using a population pharmacokinetic modelling approach.
Bartels, C; Kaiser, G; Looby, M; Sechaud, R, 2013
)
0.39
" The estimated 24-hour potency (expressed as concentration of dosing solution) was 45."( In vivo pharmacological characterization of TD-4208, a novel lung-selective inhaled muscarinic antagonist with sustained bronchoprotective effect in experimental animal models.
Hegde, SS; Jaw-Tsai, S; Ji, Y; Martin, WJ; McNamara, A; Obedencio, GP; Pulido-Rios, MT, 2013
)
0.39
" Oral glycopyrrolate is emerging as a potential second-line treatment option, but experience with safety, efficacy, and dosing is especially limited in children."( Oral glycopyrrolate for refractory pediatric and adolescent hyperhidrosis.
Bayliss, SJ; Berk, DR; Foreman, RS; Kumar, MG,
)
1.13
" When dual bronchodilation is indicated, QVA149 offers the convenience of two bronchodilators in a single inhaler coupled with a simple, once-daily dosing regimen that may encourage better treatment adherence."( QVA149 (indacaterol/glycopyrronium fixed-dose combination): a review of its use in patients with chronic obstructive pulmonary disease.
Frampton, JE, 2014
)
0.4
" In addition, these findings indicate that the correct dosage of glycopyrronium is no more than 115."( Randomized study of the safety, pharmacokinetics, and bronchodilatory efficacy of a proprietary glycopyrronium metered-dose inhaler in study patients with chronic obstructive pulmonary disease.
Darken, P; Fernandez, C; Fischer, T; Fogarty, C; Golden, M; Orevillo, C; Reisner, C; Rennard, S; Rose, ES; Tardie, G, 2014
)
0.4
"To establish the dose-response for pharmacodynamics (bronchodilatation), safety and pharmacokinetics for a nebulized formulation of the long acting muscarinic antagonist glycopyrrolate (EP-101) with a high efficiency nebulizer in patients with chronic obstructive pulmonary disease (COPD)."( Efficacy and safety of nebulized glycopyrrolate for administration using a high efficiency nebulizer in patients with chronic obstructive pulmonary disease.
Barnes, PJ; Jones, CR; Leaker, BR; Singh, D; Tutuncu, A, 2015
)
0.89
" Significant improvements in mean change from baseline FEV1 at 24 h were reported at doses ≥ 50 μg compared with placebo, with a clear dose-response relationship."( Efficacy and safety of nebulized glycopyrrolate for administration using a high efficiency nebulizer in patients with chronic obstructive pulmonary disease.
Barnes, PJ; Jones, CR; Leaker, BR; Singh, D; Tutuncu, A, 2015
)
0.7
"Adult patients undergoing abdominal surgery received rocuronium, followed by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade."( Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study.
Brueckmann, B; de Bie, J; Eikermann, M; Grobara, P; Kwo, J; Lee, J; Li, MK; Maktabi, M; McGovern, F; Pino, R; Sabouri, AS; Sasaki, N; Staehr-Rye, AK; Woo, T, 2015
)
0.61
" Virtual clinical trials were simulated and analyzed using conventional (at the end of the study) versus model-based methods to determine sample size for achieving 80% power to identify a dose-response relationship."( Pharmacometrics-guided drug development of antihyperhidrosis agents.
Dumitrescu, TP; Gobburu, J; Mehrotra, S; Schmith, VD, 2015
)
0.42
" Anaesthetized Brown Norway rats were dosed intratracheally at 1 or 6h prior to receiving increasing doses of intravenous methacholine."( Comparing the cardiovascular therapeutic indices of glycopyrronium and tiotropium in an integrated rat pharmacokinetic, pharmacodynamic and safety model.
Charlton, SJ; Collingwood, S; Ethell, BT; Kent, TC; Sykes, DA; Trifilieff, A; Watson, KJ, 2015
)
0.42
"Three spectrophotometric methods have been developed and validated for determination of indacaterol (IND) and glycopyrronium (GLY) in their binary mixtures and novel pharmaceutical dosage form."( Simultaneous spectrophotometric determination of indacaterol and glycopyrronium in a newly approved pharmaceutical formulation using different signal processing techniques of ratio spectra.
Abdel Ghany, MF; Hussein, LA; Magdy, N; Yamani, HZ, 2016
)
0.43
"To establish the dose-response relationship for pharmacodynamics (bronchodilatation), safety and pharmacokinetics of a novel particle engineered formulation of Glycopyrronium bromide (PSX1002-GB) in patients with chronic obstructive pulmonary disease (COPD)."( Bronchodilator effects, pharmacokinetics and safety of PSX1002-GB, a novel glycopyrronium bromide formulation, in COPD patients; a randomised crossover study.
Buck, H; Down, G; O'Connor, G; Ravi, A; Reid, F; Singh, D, 2016
)
0.43
"This multicentre, double-blind, randomised, placebo-controlled, crossover study aimed to determine the dose-response of the long-acting muscarinic antagonist (LAMA) glycopyrronium bromide (GB) when added to beclometasone dipropionate plus formoterol fumarate (BDP/FF) in patients with COPD."( The bronchodilator effects of extrafine glycopyrronium added to combination treatment with beclometasone dipropionate plus formoterol in COPD: A randomised crossover study (the TRIDENT study).
Bonnet-Gonod, F; Cohuet, G; Hoffmann, M; Muraro, A; Petruzzelli, S; Schröder-Babo, W; Siergiejko, Z; Singh, D, 2016
)
0.43
"The lack of commercially available liquid dosage forms for pediatric patients prompted this study."( Long-term Stability of Zonisamide, Amitriptyline, and Glycopyrrolate in Extemporaneously Prepared Liquid-dosage Forms at Two Temperatures.
Nahata, MC,
)
0.38
" In the Symptoms and Pulmonary function in the moRnING study, we prospectively compared the rapid onset bronchodilator profile of glycopyrronium (GLY) and tiotropium (TIO) during the first few hours after dosing in patients with moderate-to-severe COPD."( Early bronchodilator action of glycopyrronium versus tiotropium in moderate-to-severe COPD patients: a cross-over blinded randomized study (Symptoms and Pulmonary function in the moRnING).
Aalamian-Mattheis, M; Beeh, KM; Casamor, R; Castellani, W; Clemens, A; Gunstone, A; Kostikas, K; Marin, JM; Saralaya, D; Schaper, L, 2016
)
0.43
"This study forms part of the first complete characterization of the dose-response curve for glycopyrrolate (GP) delivered using Co-Suspension™ Delivery Technology via a metered dose inhaler (MDI)."( Dose-response to inhaled glycopyrrolate delivered with a novel Co-Suspension™ Delivery Technology metered dose inhaler (MDI) in patients with moderate-to-severe COPD.
Darken, P; Dwivedi, S; Fabbri, LM; Ferguson, GT; Fischer, T; Golden, M; Kerwin, EM; Orevillo, C; Pearle, J; Reisner, C; Rodriguez-Roisin, R; Sethi, S; Spangenthal, S; St Rose, E, 2016
)
0.96
" Here we review multiple studies from 1972 through 1986 that used varying methods of patient selection and dosage and drug combination criteria, and which noted that glycopyrrolate had a superior efficacy and adverse effect profile when compared with atropine in NMB reversal."( Glycopyrrolate: It's time to review.
D'mello, J; Howard, J; Rosen, G; Wigley, J, 2017
)
2.09
"Methacholine dose-response curves illustrate pharmacologic bronchoprotection against methacholine-induced airway hyperresponsiveness and can be used to quantitate changes in airway sensitivity (position), reactivity (slope), and maximal responsiveness following drug administration."( The effect of glycopyrronium and indacaterol, as monotherapy and in combination, on the methacholine dose-response curve of mild asthmatics: a randomized three-way crossover study.
Blais, CM; Cockcroft, DW; Davis, BE, 2017
)
0.46
"Methacholine dose-response curves differentiate the bronchoprotective mechanisms triggered by different classes of asthma medications."( The effect of glycopyrronium and indacaterol, as monotherapy and in combination, on the methacholine dose-response curve of mild asthmatics: a randomized three-way crossover study.
Blais, CM; Cockcroft, DW; Davis, BE, 2017
)
0.46
"GFF MDI significantly improved 24-h lung function versus placebo in patients with moderate-to-very severe chronic obstructive pulmonary disease, with similar benefits in the second 12-h period compared to the first, supporting twice-daily dosing of GFF MDI."( 24-h bronchodilation and inspiratory capacity improvements with glycopyrrolate/formoterol fumarate via co-suspension delivery technology in COPD.
Arora, S; Delacruz, L; Fakih, F; Feldman, G; Gottschlich, G; Koser, A; Krainson, J; Maes, A; Martin, U; Orevillo, C; Pudi, K; Reisner, C; Siddiqui, S; St Rose, E, 2017
)
0.69
" The plasma concentration-time profiles of glycopyrronium were similar following treatment with GFF MDI or GP MDI, both after single dosing and at Week 12."( Pharmacokinetics of glycopyrronium/formoterol fumarate dihydrate delivered via metered dose inhaler using co-suspension delivery technology in patients with moderate-to-very severe COPD.
Ferguson, GT; Maes, A; Martin, UJ; Reisner, C; Rodriguez-Roisin, R; Siddiqui, S, 2018
)
0.48
" Pharmacokinetic parameters were assessed following a single dose and 7-days chronic dosing with BGF MDI 160/14."( Safety and pharmacokinetics of budesonide/glycopyrronium/formoterol fumarate dihydrate metered dose inhaler (BGF MDI) in healthy adult subjects of Japanese descent.
DePetrillo, P; Dorinsky, P; Maes, A; Reisner, C; Siddiqui, S, 2018
)
0.48
"6 µg nor a clear dose-response was observed."( Efficacy and safety of four doses of glycopyrrolate/formoterol fumarate delivered via a metered dose inhaler compared with the monocomponents in patients with moderate-to-severe COPD.
Darken, P; Kerwin, EM; Pearle, J; Reisner, C; Rose, ES, 2018
)
0.75
"We conducted two studies to characterize the pharmacokinetic (PK) profile of BGF MDI in patients with COPD: (i) a phase I, open-label, single and chronic (7-day) dosing study (NCT03250182) with one treatment arm (BGF MDI 320/18/9."( Pharmacokinetics of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler formulated using co-suspension delivery technology after single and chronic dosing in patients with COPD.
Darken, P; DeAngelis, K; Dorinsky, P; Dunn, LJ; Gillen, M; Kerwin, EM, 2020
)
0.84
"Steady-state PK parameters of budesonide, glycopyrronium, and formoterol were similar after 7 days' dosing in the phase I PK study and after 24 weeks in the KRONOS PK sub-study."( Pharmacokinetics of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler formulated using co-suspension delivery technology after single and chronic dosing in patients with COPD.
Darken, P; DeAngelis, K; Dorinsky, P; Dunn, LJ; Gillen, M; Kerwin, EM, 2020
)
0.84
" Postdose efficacy assessments were performed within 60-150 min of dosing on day 15."( Functional respiratory imaging assessment of glycopyrrolate and formoterol fumarate metered dose inhalers formulated using co-suspension delivery technology in patients with COPD.
De Backer, J; De Backer, W; Fitzpatrick, J; Griffis, D; Ivanov, S; Jenkins, M; Leemans, G; Martin, UJ; Mignot, B; Reisner, C; St Rose, E; Van Holsbeke, C; Verlinden, I,
)
0.39
" The observed differences may be caused by the difference in dosing between the two regimens."( Long-acting dual bronchodilator therapy (indacaterol/glycopyrronium) versus nebulized short-acting dual bronchodilator (salbutamol/ipratropium) in chronic obstructive pulmonary disease: A double-blind, randomized, placebo-controlled trial.
Carpaij, OA; Kerstjens, HAM; Niemeijer, A; Seigers, D; van Geffen, WH; Vonk, JM; Westbroek, LF, 2020
)
0.56
" Overall, PK properties following single or repeated dosing of BGF MDI were similar across Chinese, Japanese and Western subjects."( Ethnic pharmacokinetic comparison of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler (BGF MDI) between Asian and Western healthy subjects.
Assam, PN; Dorinsky, P; Feng, C; Gillen, M; Huang, Y; Su, R, 2020
)
0.81
" Patients were treated with 1% GPB cream once daily for 4 weeks, followed by a flexible dosing scheme (min."( Long-term efficacy and safety of 1% glycopyrronium bromide cream in patients with severe primary axillary hyperhidrosis: Results from a Phase 3b trial.
Abels, C; Berger, B; Heimstaedt-Muskett, S; Kilic, A; Litzka, L; Masur, C; Reich, H; Schramm, K; Schulze Zur Wiesche, E; Szeimies, RM, 2023
)
0.91
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (2)

ClassDescription
quaternary ammonium saltDerivatives of ammonium compounds, (NH4(+))Y(-), in which all four of the hydrogens bonded to nitrogen have been replaced with univalent (usually organyl) groups.
organic bromide salt
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (9)

Potency Measurements

ProteinTaxonomyMeasurementAverage (µ)Min (ref.)Avg (ref.)Max (ref.)Bioassay(s)
estrogen nuclear receptor alphaHomo sapiens (human)Potency2.97990.000229.305416,493.5996AID743069; AID743080
cytochrome P450 2D6Homo sapiens (human)Potency15.48710.00108.379861.1304AID1645840
vitamin D3 receptor isoform VDRAHomo sapiens (human)Potency100.00000.354828.065989.1251AID504847
Cellular tumor antigen p53Homo sapiens (human)Potency7.49780.002319.595674.0614AID651631
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Inhibition Measurements

ProteinTaxonomyMeasurementAverageMin (ref.)Avg (ref.)Max (ref.)Bioassay(s)
Muscarinic acetylcholine receptor M2Homo sapiens (human)IC50 (µMol)0.00050.00001.23267.7930AID539981
Muscarinic acetylcholine receptor M2Homo sapiens (human)Ki0.00160.00000.690210.0000AID1591564
Muscarinic acetylcholine receptor M4Homo sapiens (human)IC50 (µMol)0.00020.00001.15467.5858AID539982
Muscarinic acetylcholine receptor M5Homo sapiens (human)IC50 (µMol)0.00020.00010.99178.0000AID539983
Muscarinic acetylcholine receptor M1Homo sapiens (human)IC50 (µMol)0.00010.00001.403910.0000AID539980
Muscarinic acetylcholine receptor M3Homo sapiens (human)IC50 (µMol)0.00030.00011.01049.9280AID539979
Muscarinic acetylcholine receptor M3Homo sapiens (human)Ki0.00080.00000.54057.7600AID1591563
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Biological Processes (163)

Processvia Protein(s)Taxonomy
negative regulation of cell population proliferationCellular tumor antigen p53Homo sapiens (human)
regulation of cell cycleCellular tumor antigen p53Homo sapiens (human)
regulation of cell cycle G2/M phase transitionCellular tumor antigen p53Homo sapiens (human)
DNA damage responseCellular tumor antigen p53Homo sapiens (human)
ER overload responseCellular tumor antigen p53Homo sapiens (human)
cellular response to glucose starvationCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathway in response to DNA damage by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
regulation of apoptotic processCellular tumor antigen p53Homo sapiens (human)
positive regulation of transcription by RNA polymerase IICellular tumor antigen p53Homo sapiens (human)
positive regulation of miRNA transcriptionCellular tumor antigen p53Homo sapiens (human)
negative regulation of transcription by RNA polymerase IICellular tumor antigen p53Homo sapiens (human)
mitophagyCellular tumor antigen p53Homo sapiens (human)
in utero embryonic developmentCellular tumor antigen p53Homo sapiens (human)
somitogenesisCellular tumor antigen p53Homo sapiens (human)
release of cytochrome c from mitochondriaCellular tumor antigen p53Homo sapiens (human)
hematopoietic progenitor cell differentiationCellular tumor antigen p53Homo sapiens (human)
T cell proliferation involved in immune responseCellular tumor antigen p53Homo sapiens (human)
B cell lineage commitmentCellular tumor antigen p53Homo sapiens (human)
T cell lineage commitmentCellular tumor antigen p53Homo sapiens (human)
response to ischemiaCellular tumor antigen p53Homo sapiens (human)
nucleotide-excision repairCellular tumor antigen p53Homo sapiens (human)
double-strand break repairCellular tumor antigen p53Homo sapiens (human)
regulation of DNA-templated transcriptionCellular tumor antigen p53Homo sapiens (human)
regulation of transcription by RNA polymerase IICellular tumor antigen p53Homo sapiens (human)
protein import into nucleusCellular tumor antigen p53Homo sapiens (human)
autophagyCellular tumor antigen p53Homo sapiens (human)
DNA damage responseCellular tumor antigen p53Homo sapiens (human)
DNA damage response, signal transduction by p53 class mediator resulting in cell cycle arrestCellular tumor antigen p53Homo sapiens (human)
DNA damage response, signal transduction by p53 class mediator resulting in transcription of p21 class mediatorCellular tumor antigen p53Homo sapiens (human)
transforming growth factor beta receptor signaling pathwayCellular tumor antigen p53Homo sapiens (human)
Ras protein signal transductionCellular tumor antigen p53Homo sapiens (human)
gastrulationCellular tumor antigen p53Homo sapiens (human)
neuroblast proliferationCellular tumor antigen p53Homo sapiens (human)
negative regulation of neuroblast proliferationCellular tumor antigen p53Homo sapiens (human)
protein localizationCellular tumor antigen p53Homo sapiens (human)
negative regulation of DNA replicationCellular tumor antigen p53Homo sapiens (human)
negative regulation of cell population proliferationCellular tumor antigen p53Homo sapiens (human)
determination of adult lifespanCellular tumor antigen p53Homo sapiens (human)
mRNA transcriptionCellular tumor antigen p53Homo sapiens (human)
rRNA transcriptionCellular tumor antigen p53Homo sapiens (human)
response to salt stressCellular tumor antigen p53Homo sapiens (human)
response to inorganic substanceCellular tumor antigen p53Homo sapiens (human)
response to X-rayCellular tumor antigen p53Homo sapiens (human)
response to gamma radiationCellular tumor antigen p53Homo sapiens (human)
positive regulation of gene expressionCellular tumor antigen p53Homo sapiens (human)
cardiac muscle cell apoptotic processCellular tumor antigen p53Homo sapiens (human)
positive regulation of cardiac muscle cell apoptotic processCellular tumor antigen p53Homo sapiens (human)
glial cell proliferationCellular tumor antigen p53Homo sapiens (human)
viral processCellular tumor antigen p53Homo sapiens (human)
glucose catabolic process to lactate via pyruvateCellular tumor antigen p53Homo sapiens (human)
cerebellum developmentCellular tumor antigen p53Homo sapiens (human)
negative regulation of cell growthCellular tumor antigen p53Homo sapiens (human)
DNA damage response, signal transduction by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
negative regulation of transforming growth factor beta receptor signaling pathwayCellular tumor antigen p53Homo sapiens (human)
mitotic G1 DNA damage checkpoint signalingCellular tumor antigen p53Homo sapiens (human)
negative regulation of telomere maintenance via telomeraseCellular tumor antigen p53Homo sapiens (human)
T cell differentiation in thymusCellular tumor antigen p53Homo sapiens (human)
tumor necrosis factor-mediated signaling pathwayCellular tumor antigen p53Homo sapiens (human)
regulation of tissue remodelingCellular tumor antigen p53Homo sapiens (human)
cellular response to UVCellular tumor antigen p53Homo sapiens (human)
multicellular organism growthCellular tumor antigen p53Homo sapiens (human)
positive regulation of mitochondrial membrane permeabilityCellular tumor antigen p53Homo sapiens (human)
cellular response to glucose starvationCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathway in response to DNA damage by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
positive regulation of apoptotic processCellular tumor antigen p53Homo sapiens (human)
negative regulation of apoptotic processCellular tumor antigen p53Homo sapiens (human)
entrainment of circadian clock by photoperiodCellular tumor antigen p53Homo sapiens (human)
mitochondrial DNA repairCellular tumor antigen p53Homo sapiens (human)
regulation of DNA damage response, signal transduction by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
positive regulation of neuron apoptotic processCellular tumor antigen p53Homo sapiens (human)
transcription initiation-coupled chromatin remodelingCellular tumor antigen p53Homo sapiens (human)
negative regulation of proteolysisCellular tumor antigen p53Homo sapiens (human)
negative regulation of DNA-templated transcriptionCellular tumor antigen p53Homo sapiens (human)
positive regulation of DNA-templated transcriptionCellular tumor antigen p53Homo sapiens (human)
positive regulation of RNA polymerase II transcription preinitiation complex assemblyCellular tumor antigen p53Homo sapiens (human)
positive regulation of transcription by RNA polymerase IICellular tumor antigen p53Homo sapiens (human)
response to antibioticCellular tumor antigen p53Homo sapiens (human)
fibroblast proliferationCellular tumor antigen p53Homo sapiens (human)
negative regulation of fibroblast proliferationCellular tumor antigen p53Homo sapiens (human)
circadian behaviorCellular tumor antigen p53Homo sapiens (human)
bone marrow developmentCellular tumor antigen p53Homo sapiens (human)
embryonic organ developmentCellular tumor antigen p53Homo sapiens (human)
positive regulation of peptidyl-tyrosine phosphorylationCellular tumor antigen p53Homo sapiens (human)
protein stabilizationCellular tumor antigen p53Homo sapiens (human)
negative regulation of helicase activityCellular tumor antigen p53Homo sapiens (human)
protein tetramerizationCellular tumor antigen p53Homo sapiens (human)
chromosome organizationCellular tumor antigen p53Homo sapiens (human)
neuron apoptotic processCellular tumor antigen p53Homo sapiens (human)
regulation of cell cycleCellular tumor antigen p53Homo sapiens (human)
hematopoietic stem cell differentiationCellular tumor antigen p53Homo sapiens (human)
negative regulation of glial cell proliferationCellular tumor antigen p53Homo sapiens (human)
type II interferon-mediated signaling pathwayCellular tumor antigen p53Homo sapiens (human)
cardiac septum morphogenesisCellular tumor antigen p53Homo sapiens (human)
positive regulation of programmed necrotic cell deathCellular tumor antigen p53Homo sapiens (human)
protein-containing complex assemblyCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathway in response to endoplasmic reticulum stressCellular tumor antigen p53Homo sapiens (human)
thymocyte apoptotic processCellular tumor antigen p53Homo sapiens (human)
positive regulation of thymocyte apoptotic processCellular tumor antigen p53Homo sapiens (human)
necroptotic processCellular tumor antigen p53Homo sapiens (human)
cellular response to hypoxiaCellular tumor antigen p53Homo sapiens (human)
cellular response to xenobiotic stimulusCellular tumor antigen p53Homo sapiens (human)
cellular response to ionizing radiationCellular tumor antigen p53Homo sapiens (human)
cellular response to gamma radiationCellular tumor antigen p53Homo sapiens (human)
cellular response to UV-CCellular tumor antigen p53Homo sapiens (human)
stem cell proliferationCellular tumor antigen p53Homo sapiens (human)
signal transduction by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathway by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
reactive oxygen species metabolic processCellular tumor antigen p53Homo sapiens (human)
cellular response to actinomycin DCellular tumor antigen p53Homo sapiens (human)
positive regulation of release of cytochrome c from mitochondriaCellular tumor antigen p53Homo sapiens (human)
cellular senescenceCellular tumor antigen p53Homo sapiens (human)
replicative senescenceCellular tumor antigen p53Homo sapiens (human)
oxidative stress-induced premature senescenceCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathwayCellular tumor antigen p53Homo sapiens (human)
oligodendrocyte apoptotic processCellular tumor antigen p53Homo sapiens (human)
positive regulation of execution phase of apoptosisCellular tumor antigen p53Homo sapiens (human)
negative regulation of mitophagyCellular tumor antigen p53Homo sapiens (human)
regulation of mitochondrial membrane permeability involved in apoptotic processCellular tumor antigen p53Homo sapiens (human)
regulation of intrinsic apoptotic signaling pathway by p53 class mediatorCellular tumor antigen p53Homo sapiens (human)
positive regulation of miRNA transcriptionCellular tumor antigen p53Homo sapiens (human)
negative regulation of G1 to G0 transitionCellular tumor antigen p53Homo sapiens (human)
negative regulation of miRNA processingCellular tumor antigen p53Homo sapiens (human)
negative regulation of glucose catabolic process to lactate via pyruvateCellular tumor antigen p53Homo sapiens (human)
negative regulation of pentose-phosphate shuntCellular tumor antigen p53Homo sapiens (human)
intrinsic apoptotic signaling pathway in response to hypoxiaCellular tumor antigen p53Homo sapiens (human)
regulation of fibroblast apoptotic processCellular tumor antigen p53Homo sapiens (human)
negative regulation of reactive oxygen species metabolic processCellular tumor antigen p53Homo sapiens (human)
positive regulation of reactive oxygen species metabolic processCellular tumor antigen p53Homo sapiens (human)
negative regulation of stem cell proliferationCellular tumor antigen p53Homo sapiens (human)
positive regulation of cellular senescenceCellular tumor antigen p53Homo sapiens (human)
positive regulation of intrinsic apoptotic signaling pathwayCellular tumor antigen p53Homo sapiens (human)
G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
adenylate cyclase-modulating G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
phospholipase C-activating G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
nervous system developmentMuscarinic acetylcholine receptor M2Homo sapiens (human)
regulation of heart contractionMuscarinic acetylcholine receptor M2Homo sapiens (human)
response to virusMuscarinic acetylcholine receptor M2Homo sapiens (human)
G protein-coupled serotonin receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
presynaptic modulation of chemical synaptic transmissionMuscarinic acetylcholine receptor M2Homo sapiens (human)
regulation of smooth muscle contractionMuscarinic acetylcholine receptor M2Homo sapiens (human)
adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M2Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerMuscarinic acetylcholine receptor M2Homo sapiens (human)
chemical synaptic transmissionMuscarinic acetylcholine receptor M2Homo sapiens (human)
signal transductionMuscarinic acetylcholine receptor M4Homo sapiens (human)
cell surface receptor signaling pathwayMuscarinic acetylcholine receptor M4Homo sapiens (human)
G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M4Homo sapiens (human)
regulation of locomotionMuscarinic acetylcholine receptor M4Homo sapiens (human)
G protein-coupled serotonin receptor signaling pathwayMuscarinic acetylcholine receptor M4Homo sapiens (human)
adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M4Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerMuscarinic acetylcholine receptor M4Homo sapiens (human)
chemical synaptic transmissionMuscarinic acetylcholine receptor M4Homo sapiens (human)
gastric acid secretionMuscarinic acetylcholine receptor M5Homo sapiens (human)
G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M5Homo sapiens (human)
dopamine transportMuscarinic acetylcholine receptor M5Homo sapiens (human)
transmission of nerve impulseMuscarinic acetylcholine receptor M5Homo sapiens (human)
regulation of phosphatidylinositol dephosphorylationMuscarinic acetylcholine receptor M5Homo sapiens (human)
G protein-coupled serotonin receptor signaling pathwayMuscarinic acetylcholine receptor M5Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerMuscarinic acetylcholine receptor M5Homo sapiens (human)
chemical synaptic transmissionMuscarinic acetylcholine receptor M5Homo sapiens (human)
adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M5Homo sapiens (human)
positive regulation of monoatomic ion transportMuscarinic acetylcholine receptor M1Homo sapiens (human)
signal transductionMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
protein kinase C-activating G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
phospholipase C-activating G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
neuromuscular synaptic transmissionMuscarinic acetylcholine receptor M1Homo sapiens (human)
nervous system developmentMuscarinic acetylcholine receptor M1Homo sapiens (human)
regulation of locomotionMuscarinic acetylcholine receptor M1Homo sapiens (human)
saliva secretionMuscarinic acetylcholine receptor M1Homo sapiens (human)
cognitionMuscarinic acetylcholine receptor M1Homo sapiens (human)
regulation of postsynaptic membrane potentialMuscarinic acetylcholine receptor M1Homo sapiens (human)
regulation of glial cell proliferationMuscarinic acetylcholine receptor M1Homo sapiens (human)
positive regulation of intracellular protein transportMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled serotonin receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
postsynaptic modulation of chemical synaptic transmissionMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerMuscarinic acetylcholine receptor M1Homo sapiens (human)
adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M1Homo sapiens (human)
chemical synaptic transmissionMuscarinic acetylcholine receptor M1Homo sapiens (human)
calcium-mediated signalingMuscarinic acetylcholine receptor M3Homo sapiens (human)
regulation of monoatomic ion transmembrane transporter activityMuscarinic acetylcholine receptor M3Homo sapiens (human)
smooth muscle contractionMuscarinic acetylcholine receptor M3Homo sapiens (human)
signal transductionMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
phospholipase C-activating G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
synaptic transmission, cholinergicMuscarinic acetylcholine receptor M3Homo sapiens (human)
nervous system developmentMuscarinic acetylcholine receptor M3Homo sapiens (human)
positive regulation of insulin secretionMuscarinic acetylcholine receptor M3Homo sapiens (human)
protein modification processMuscarinic acetylcholine receptor M3Homo sapiens (human)
positive regulation of smooth muscle contractionMuscarinic acetylcholine receptor M3Homo sapiens (human)
saliva secretionMuscarinic acetylcholine receptor M3Homo sapiens (human)
acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled serotonin receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
ion channel modulating, G protein-coupled receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
ligand-gated ion channel signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
regulation of smooth muscle contractionMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled receptor signaling pathway, coupled to cyclic nucleotide second messengerMuscarinic acetylcholine receptor M3Homo sapiens (human)
adenylate cyclase-inhibiting G protein-coupled acetylcholine receptor signaling pathwayMuscarinic acetylcholine receptor M3Homo sapiens (human)
chemical synaptic transmissionMuscarinic acetylcholine receptor M3Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Molecular Functions (40)

Processvia Protein(s)Taxonomy
transcription cis-regulatory region bindingCellular tumor antigen p53Homo sapiens (human)
RNA polymerase II cis-regulatory region sequence-specific DNA bindingCellular tumor antigen p53Homo sapiens (human)
DNA-binding transcription factor activity, RNA polymerase II-specificCellular tumor antigen p53Homo sapiens (human)
cis-regulatory region sequence-specific DNA bindingCellular tumor antigen p53Homo sapiens (human)
core promoter sequence-specific DNA bindingCellular tumor antigen p53Homo sapiens (human)
TFIID-class transcription factor complex bindingCellular tumor antigen p53Homo sapiens (human)
DNA-binding transcription repressor activity, RNA polymerase II-specificCellular tumor antigen p53Homo sapiens (human)
DNA-binding transcription activator activity, RNA polymerase II-specificCellular tumor antigen p53Homo sapiens (human)
protease bindingCellular tumor antigen p53Homo sapiens (human)
p53 bindingCellular tumor antigen p53Homo sapiens (human)
DNA bindingCellular tumor antigen p53Homo sapiens (human)
chromatin bindingCellular tumor antigen p53Homo sapiens (human)
DNA-binding transcription factor activityCellular tumor antigen p53Homo sapiens (human)
mRNA 3'-UTR bindingCellular tumor antigen p53Homo sapiens (human)
copper ion bindingCellular tumor antigen p53Homo sapiens (human)
protein bindingCellular tumor antigen p53Homo sapiens (human)
zinc ion bindingCellular tumor antigen p53Homo sapiens (human)
enzyme bindingCellular tumor antigen p53Homo sapiens (human)
receptor tyrosine kinase bindingCellular tumor antigen p53Homo sapiens (human)
ubiquitin protein ligase bindingCellular tumor antigen p53Homo sapiens (human)
histone deacetylase regulator activityCellular tumor antigen p53Homo sapiens (human)
ATP-dependent DNA/DNA annealing activityCellular tumor antigen p53Homo sapiens (human)
identical protein bindingCellular tumor antigen p53Homo sapiens (human)
histone deacetylase bindingCellular tumor antigen p53Homo sapiens (human)
protein heterodimerization activityCellular tumor antigen p53Homo sapiens (human)
protein-folding chaperone bindingCellular tumor antigen p53Homo sapiens (human)
protein phosphatase 2A bindingCellular tumor antigen p53Homo sapiens (human)
RNA polymerase II-specific DNA-binding transcription factor bindingCellular tumor antigen p53Homo sapiens (human)
14-3-3 protein bindingCellular tumor antigen p53Homo sapiens (human)
MDM2/MDM4 family protein bindingCellular tumor antigen p53Homo sapiens (human)
disordered domain specific bindingCellular tumor antigen p53Homo sapiens (human)
general transcription initiation factor bindingCellular tumor antigen p53Homo sapiens (human)
molecular function activator activityCellular tumor antigen p53Homo sapiens (human)
promoter-specific chromatin bindingCellular tumor antigen p53Homo sapiens (human)
G protein-coupled acetylcholine receptor activityMuscarinic acetylcholine receptor M2Homo sapiens (human)
arrestin family protein bindingMuscarinic acetylcholine receptor M2Homo sapiens (human)
G protein-coupled serotonin receptor activityMuscarinic acetylcholine receptor M2Homo sapiens (human)
G protein-coupled serotonin receptor activityMuscarinic acetylcholine receptor M4Homo sapiens (human)
G protein-coupled acetylcholine receptor activityMuscarinic acetylcholine receptor M4Homo sapiens (human)
phosphatidylinositol phospholipase C activityMuscarinic acetylcholine receptor M5Homo sapiens (human)
protein bindingMuscarinic acetylcholine receptor M5Homo sapiens (human)
G protein-coupled acetylcholine receptor activityMuscarinic acetylcholine receptor M5Homo sapiens (human)
G protein-coupled serotonin receptor activityMuscarinic acetylcholine receptor M5Homo sapiens (human)
phosphatidylinositol phospholipase C activityMuscarinic acetylcholine receptor M1Homo sapiens (human)
protein bindingMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled acetylcholine receptor activityMuscarinic acetylcholine receptor M1Homo sapiens (human)
G protein-coupled serotonin receptor activityMuscarinic acetylcholine receptor M1Homo sapiens (human)
phosphatidylinositol phospholipase C activityMuscarinic acetylcholine receptor M3Homo sapiens (human)
protein bindingMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled acetylcholine receptor activityMuscarinic acetylcholine receptor M3Homo sapiens (human)
signaling receptor activityMuscarinic acetylcholine receptor M3Homo sapiens (human)
acetylcholine bindingMuscarinic acetylcholine receptor M3Homo sapiens (human)
G protein-coupled serotonin receptor activityMuscarinic acetylcholine receptor M3Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Ceullar Components (37)

Processvia Protein(s)Taxonomy
nuclear bodyCellular tumor antigen p53Homo sapiens (human)
nucleusCellular tumor antigen p53Homo sapiens (human)
nucleoplasmCellular tumor antigen p53Homo sapiens (human)
replication forkCellular tumor antigen p53Homo sapiens (human)
nucleolusCellular tumor antigen p53Homo sapiens (human)
cytoplasmCellular tumor antigen p53Homo sapiens (human)
mitochondrionCellular tumor antigen p53Homo sapiens (human)
mitochondrial matrixCellular tumor antigen p53Homo sapiens (human)
endoplasmic reticulumCellular tumor antigen p53Homo sapiens (human)
centrosomeCellular tumor antigen p53Homo sapiens (human)
cytosolCellular tumor antigen p53Homo sapiens (human)
nuclear matrixCellular tumor antigen p53Homo sapiens (human)
PML bodyCellular tumor antigen p53Homo sapiens (human)
transcription repressor complexCellular tumor antigen p53Homo sapiens (human)
site of double-strand breakCellular tumor antigen p53Homo sapiens (human)
germ cell nucleusCellular tumor antigen p53Homo sapiens (human)
chromatinCellular tumor antigen p53Homo sapiens (human)
transcription regulator complexCellular tumor antigen p53Homo sapiens (human)
protein-containing complexCellular tumor antigen p53Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
clathrin-coated endocytic vesicle membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
asymmetric synapseMuscarinic acetylcholine receptor M2Homo sapiens (human)
symmetric synapseMuscarinic acetylcholine receptor M2Homo sapiens (human)
presynaptic membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
neuronal cell bodyMuscarinic acetylcholine receptor M2Homo sapiens (human)
axon terminusMuscarinic acetylcholine receptor M2Homo sapiens (human)
postsynaptic membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
glutamatergic synapseMuscarinic acetylcholine receptor M2Homo sapiens (human)
cholinergic synapseMuscarinic acetylcholine receptor M2Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M2Homo sapiens (human)
synapseMuscarinic acetylcholine receptor M2Homo sapiens (human)
dendriteMuscarinic acetylcholine receptor M2Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M4Homo sapiens (human)
postsynaptic membraneMuscarinic acetylcholine receptor M4Homo sapiens (human)
dendriteMuscarinic acetylcholine receptor M4Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M4Homo sapiens (human)
synapseMuscarinic acetylcholine receptor M4Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M5Homo sapiens (human)
postsynaptic membraneMuscarinic acetylcholine receptor M5Homo sapiens (human)
dendriteMuscarinic acetylcholine receptor M5Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M5Homo sapiens (human)
synapseMuscarinic acetylcholine receptor M5Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M1Homo sapiens (human)
membraneMuscarinic acetylcholine receptor M1Homo sapiens (human)
presynaptic membraneMuscarinic acetylcholine receptor M1Homo sapiens (human)
axon terminusMuscarinic acetylcholine receptor M1Homo sapiens (human)
Schaffer collateral - CA1 synapseMuscarinic acetylcholine receptor M1Homo sapiens (human)
postsynaptic density membraneMuscarinic acetylcholine receptor M1Homo sapiens (human)
glutamatergic synapseMuscarinic acetylcholine receptor M1Homo sapiens (human)
cholinergic synapseMuscarinic acetylcholine receptor M1Homo sapiens (human)
synapseMuscarinic acetylcholine receptor M1Homo sapiens (human)
dendriteMuscarinic acetylcholine receptor M1Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M1Homo sapiens (human)
endoplasmic reticulum membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
basal plasma membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
basolateral plasma membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
postsynaptic membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
synapseMuscarinic acetylcholine receptor M3Homo sapiens (human)
plasma membraneMuscarinic acetylcholine receptor M3Homo sapiens (human)
dendriteMuscarinic acetylcholine receptor M3Homo sapiens (human)
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (77)

Assay IDTitleYearJournalArticle
AID651635Viability Counterscreen for Primary qHTS for Inhibitors of ATXN expression
AID1296008Cytotoxic Profiling of Annotated Libraries Using Quantitative High-Throughput Screening2020SLAS discovery : advancing life sciences R & D, 01, Volume: 25, Issue:1
Cytotoxic Profiling of Annotated and Diverse Chemical Libraries Using Quantitative High-Throughput Screening.
AID1346987P-glycoprotein substrates identified in KB-8-5-11 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1346986P-glycoprotein substrates identified in KB-3-1 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1347104qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for RD cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347091qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SJ-GBM2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347100qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for LAN-5 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347096qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for U-2 OS cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347094qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-37 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347108qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh41 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347105qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for MG 63 (6-TG R) cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347107qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh30 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1508630Primary qHTS for small molecule stabilizers of the endoplasmic reticulum resident proteome: Secreted ER Calcium Modulated Protein (SERCaMP) assay2021Cell reports, 04-27, Volume: 35, Issue:4
A target-agnostic screen identifies approved drugs to stabilize the endoplasmic reticulum-resident proteome.
AID1347103qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for OHS-50 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347407qHTS to identify inhibitors of the type 1 interferon - major histocompatibility complex class I in skeletal muscle: primary screen against the NCATS Pharmaceutical Collection2020ACS chemical biology, 07-17, Volume: 15, Issue:7
High-Throughput Screening to Identify Inhibitors of the Type I Interferon-Major Histocompatibility Complex Class I Pathway in Skeletal Muscle.
AID1347098qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-SH cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347424RapidFire Mass Spectrometry qHTS Assay for Modulators of WT P53-Induced Phosphatase 1 (WIP1)2019The Journal of biological chemistry, 11-15, Volume: 294, Issue:46
Physiologically relevant orthogonal assays for the discovery of small-molecule modulators of WIP1 phosphatase in high-throughput screens.
AID1347083qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: Viability assay - alamar blue signal for LASV Primary Screen2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347101qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-12 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347082qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: LASV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347425Rhodamine-PBP qHTS Assay for Modulators of WT P53-Induced Phosphatase 1 (WIP1)2019The Journal of biological chemistry, 11-15, Volume: 294, Issue:46
Physiologically relevant orthogonal assays for the discovery of small-molecule modulators of WIP1 phosphatase in high-throughput screens.
AID1347102qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh18 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347092qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for A673 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347106qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for control Hh wild type fibroblast cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1745845Primary qHTS for Inhibitors of ATXN expression
AID1347089qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for TC32 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347099qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB1643 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347097qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Saos-2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347090qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for DAOY cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347154Primary screen GU AMC qHTS for Zika virus inhibitors2020Proceedings of the National Academy of Sciences of the United States of America, 12-08, Volume: 117, Issue:49
Therapeutic candidates for the Zika virus identified by a high-throughput screen for Zika protease inhibitors.
AID1347093qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-MC cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347086qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lymphocytic Choriomeningitis Arenaviruses (LCMV): LCMV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347095qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB-EBc1 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588499High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain A protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588501High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Lethal Factor Protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2010Current protocols in cytometry, Oct, Volume: Chapter 13Microsphere-based flow cytometry protease assays for use in protease activity detection and high-throughput screening.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2006Cytometry. Part A : the journal of the International Society for Analytical Cytology, May, Volume: 69, Issue:5
Microsphere-based protease assays and screening application for lethal factor and factor Xa.
AID588497High-throughput multiplex microsphere screening for inhibitors of toxin protease, specifically Botulinum neurotoxin light chain F protease, MLPCN compound set2010Assay and drug development technologies, Feb, Volume: 8, Issue:1
High-throughput multiplex flow cytometry screening for botulinum neurotoxin type a light chain protease inhibitors.
AID625279Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for bilirubinemia2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID625284Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for hepatic failure2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1224077Effect on CCh-induced salivation in Sprague-Dawley rat after 24 hrs2014Bioorganic & medicinal chemistry, Jul-01, Volume: 22, Issue:13
Novel quinuclidinyl heteroarylcarbamate derivatives as muscarinic receptor antagonists.
AID625289Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for liver disease2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID625292Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) combined score2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1224075Bronchodilatory effect in it dosed Sprague-Dawley rat assessed as inhibition of CCh-induced bronchoconstriction after 24 hrs2014Bioorganic & medicinal chemistry, Jul-01, Volume: 22, Issue:13
Novel quinuclidinyl heteroarylcarbamate derivatives as muscarinic receptor antagonists.
AID625281Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for cholelithiasis2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID771315Cellular uptake in human HEK293 cells assessed as human OCT1-mediated drug transport at 2.5 uM after 4 mins by LC-MS/MS analysis relative to passive uptake2013Journal of medicinal chemistry, Sep-26, Volume: 56, Issue:18
Identification of novel substrates and structure-activity relationship of cellular uptake mediated by human organic cation transporters 1 and 2.
AID625286Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for hepatitis2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID625282Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for cirrhosis2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID539983Displacement of [3H]NMS from human muscarinic M5 receptor expressed in CHO-K1 cells after 16 hrs by scintillation proximity assay2010Bioorganic & medicinal chemistry letters, Dec-15, Volume: 20, Issue:24
The discovery of new spirocyclic muscarinic M3 antagonists.
AID1591568Bronchodilatory activity in tracheotomized ICR mouse assessed as suppression of methacholine-induced increase in airway resistance at 3.6 ug/kg administered intratracheally 1 hr before by methacholine challenge2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID1591564Displacement of [3H]NMS from human M2R expressed in CHOK1 cell membranes incubated for 2 hrs by microbeta scintillation counting method2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID771314Cellular uptake in human HEK293 cells assessed as human OCT2-mediated drug transport at 2.5 uM after 4 mins by LC-MS/MS analysis relative to passive uptake2013Journal of medicinal chemistry, Sep-26, Volume: 56, Issue:18
Identification of novel substrates and structure-activity relationship of cellular uptake mediated by human organic cation transporters 1 and 2.
AID1591577Bronchodilatory activity in tracheotomized ICR mouse at 3.6 ug/kg administered intratracheally measured after 96 hrs2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID625280Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for cholecystitis2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1591575Bronchodilatory activity in tracheotomized ICR mouse at 3.6 ug/kg administered intratracheally measured after 72 hrs2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID539981Displacement of [3H]NMS from human muscarinic M2 receptor expressed in CHO-K1 cells after 16 hrs by scintillation proximity assay2010Bioorganic & medicinal chemistry letters, Dec-15, Volume: 20, Issue:24
The discovery of new spirocyclic muscarinic M3 antagonists.
AID771317Cellular uptake in human HEK293 cells assessed as human OCT1-mediated drug transport at 2.5 uM after 4 mins by LC-MS/MS analysis2013Journal of medicinal chemistry, Sep-26, Volume: 56, Issue:18
Identification of novel substrates and structure-activity relationship of cellular uptake mediated by human organic cation transporters 1 and 2.
AID771316Cellular uptake in human HEK293 cells assessed as human OCT2-mediated drug transport at 2.5 uM after 4 mins by LC-MS/MS analysis2013Journal of medicinal chemistry, Sep-26, Volume: 56, Issue:18
Identification of novel substrates and structure-activity relationship of cellular uptake mediated by human organic cation transporters 1 and 2.
AID625290Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for liver fatty2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1591572Bronchodilatory activity in tracheotomized ICR mouse at 3.6 ug/kg administered intratracheally measured after 48 hrs2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID625283Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for elevated liver function tests2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1224076Ratio of ID50 for effect on CCh-induced salivation in Sprague-Dawley rat to ID50 for inhibition of CCh-induced bronchoconstriction Sprague-Dawley rat2014Bioorganic & medicinal chemistry, Jul-01, Volume: 22, Issue:13
Novel quinuclidinyl heteroarylcarbamate derivatives as muscarinic receptor antagonists.
AID539979Displacement of [3H]NMS from human muscarinic M3 receptor expressed in CHO-K1 cells after 16 hrs by scintillation proximity assay2010Bioorganic & medicinal chemistry letters, Dec-15, Volume: 20, Issue:24
The discovery of new spirocyclic muscarinic M3 antagonists.
AID539982Displacement of [3H]NMS from human muscarinic M4 receptor expressed in CHO-K1 cells after 16 hrs by scintillation proximity assay2010Bioorganic & medicinal chemistry letters, Dec-15, Volume: 20, Issue:24
The discovery of new spirocyclic muscarinic M3 antagonists.
AID625288Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for jaundice2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1224081Bronchodilatory effect in it dosed Sprague-Dawley rat assessed as inhibition of CCh-induced bronchoconstriction at 15 mins to 1 hr2014Bioorganic & medicinal chemistry, Jul-01, Volume: 22, Issue:13
Novel quinuclidinyl heteroarylcarbamate derivatives as muscarinic receptor antagonists.
AID539980Displacement of [3H]NMS from human muscarinic M1 receptor expressed in CHO-K1 cells after 16 hrs by scintillation proximity assay2010Bioorganic & medicinal chemistry letters, Dec-15, Volume: 20, Issue:24
The discovery of new spirocyclic muscarinic M3 antagonists.
AID625285Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for hepatic necrosis2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID625287Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for hepatomegaly2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID1591563Displacement of [3H]NMS from human M3R expressed in CHOK1 cell membranes incubated for 2 hrs by microbeta scintillation counting method2019Bioorganic & medicinal chemistry, 08-01, Volume: 27, Issue:15
Chemical modification-mediated optimisation of bronchodilatory activity of mepenzolate, a muscarinic receptor antagonist with anti-inflammatory activity.
AID625291Drug Induced Liver Injury Prediction System (DILIps) training set; hepatic side effect (HepSE) score for liver function tests abnormal2011PLoS computational biology, Dec, Volume: 7, Issue:12
Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps).
AID588519A screen for compounds that inhibit viral RNA polymerase binding and polymerization activities2011Antiviral research, Sep, Volume: 91, Issue:3
High-throughput screening identification of poliovirus RNA-dependent RNA polymerase inhibitors.
AID540299A screen for compounds that inhibit the MenB enzyme of Mycobacterium tuberculosis2010Bioorganic & medicinal chemistry letters, Nov-01, Volume: 20, Issue:21
Synthesis and SAR studies of 1,4-benzoxazine MenB inhibitors: novel antibacterial agents against Mycobacterium tuberculosis.
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (1,109)

TimeframeStudies, This Drug (%)All Drugs %
pre-1990268 (24.17)18.7374
1990's154 (13.89)18.2507
2000's141 (12.71)29.6817
2010's381 (34.36)24.3611
2020's165 (14.88)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 96.72

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be very strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index96.72 (24.57)
Research Supply Index7.38 (2.92)
Research Growth Index4.88 (4.65)
Search Engine Demand Index177.47 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (96.72)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials404 (33.72%)5.53%
Reviews121 (10.10%)6.00%
Case Studies135 (11.27%)4.05%
Observational10 (0.83%)0.25%
Other528 (44.07%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (186)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Randomized, Double-blind, Placebo Controlled, Parallel Group, Multi-center Study, to Assess the Safety and Tolerability of 28 Days Treatment With NVA237 (100 or 200 µg Once a Day) in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease [NCT00510510]Phase 2281 participants (Actual)Interventional2007-08-31Completed
Evaluation of the Anti-inflammatory Effects of Glycopyrronium Added to Indacaterol/Mometasone on the Allergen-induced Late Asthmatic Response [NCT04259164]Phase 328 participants (Actual)Interventional2020-09-10Completed
The Effect of Sugammadex of EEG-derived Index Values [NCT01142648]Phase 430 participants (Anticipated)Interventional2009-04-30Completed
A Randomized, Double-Blind, Chronic Dosing (7-Day), Four-Period, Four-Treatment, Placebo-Controlled, Cross-Over, Multi-Center Study to Assess the Efficacy and Safety of Three Doses of PT001 in Japanese Subjects With Moderate to Severe COPD [NCT03256552]Phase 266 participants (Actual)Interventional2015-01-28Completed
A Prospective, Double-blind, Randomized Study to Investigate the Effect of Sugammadex vs. Neostigmine/Glycopyrrolate on Emergence Delirium During Sevoflurane-rocuronium Anesthesia in Pediatric Patients [NCT03229486]Phase 440 participants (Actual)Interventional2017-03-01Completed
Pharmacokinetic, Randomized, Open-label, Single-dose, 3-way Cross-over Study of Intravenous and Inhaled Glycopyrrolate With or Without Charcoal Block Ingestion in Healthy Volunteers. [NCT01176851]Phase 120 participants (Anticipated)Interventional2010-07-31Completed
A Phase I, Randomised, Two-Period, Single-Dose, Single-Centre, Crossover Gamma Scintigraphy Study to Assess the Pulmonary Deposition of Technetium-99m Radiolabelled Budesonide, Glycopyrronium and Formoterol Fumarate MDI, Following 3 s and 10 s Breath-Hold [NCT03740373]Phase 110 participants (Actual)Interventional2018-09-04Completed
A Phase 4 Double-Blinded, Randomized, Active Comparator-Controlled Clinical Trial to Study the Efficacy, Safety, and Pharmacokinetics of Sugammadex (MK-8616) for Reversal of Neuromuscular Blockade in Pediatric Participants [NCT03351608]Phase 4288 participants (Actual)Interventional2018-02-12Completed
A Phase 4 Randomized, Active-Comparator Controlled Trial to Study the Efficacy and Safety of Sugammadex (MK-8616) for the Reversal of Neuromuscular Blockade Induced by Either Rocuronium Bromide or Vecuronium Bromide in Morbidly Obese Subjects [NCT03346070]Phase 4207 participants (Actual)Interventional2018-01-01Completed
Randomized, Placebo-Controlled, Double-Blind, Dose Ranging, Single-Dose, 6-Way Crossover Study to Assess Safety, Efficacy and Pharmacokinetics of EP-101 Using eFlow Nebuliser in Patients With COPD [NCT02948582]Phase 242 participants (Actual)Interventional2010-07-31Completed
Randomized, Double-blind, Placebo-controlled, Cross-over Study to Investigate the Bronchodilator Efficacy and Safety After Single and Repeated Administrations of Different Doses of Glycopyrrolate Via pMDI in Moderate to Severe COPD Patients. [NCT01176903]Phase 1/Phase 265 participants (Actual)Interventional2010-08-31Completed
A Phase 4 Randomized, Active-Comparator Controlled Clinical Trial to Study the Safety of Sugammadex (MK-8616) for the Reversal of Neuromuscular Blockade Induced by Either Rocuronium Bromide or Vecuronium Bromide in American Society of Anesthesiologists (A [NCT03346057]Phase 4344 participants (Actual)Interventional2017-12-20Completed
A Novel Application of Iontophoresis in the Transcutaneous Delivery of a Prokinetic Agent for the Promotion of Bowel Evacuation [NCT02370862]Early Phase 128 participants (Actual)Interventional2013-02-28Completed
A Randomised, Double-Blind, Double-Dummy, Multicentre, Parallel Group Study to Assess the Efficacy and Safety of Glycopyrronium/Formoterol Fumarate Fixed-dose Combination Relative to Umeclidinium/Vilanterol Fixed-dose Combination Over 24 Weeks in Patients [NCT03162055]Phase 31,119 participants (Actual)Interventional2017-05-25Completed
A Phase I, Randomized, Double-Blind, Parallel-Group, Study to Assess the Pharmacokinetics and Safety of Two Doses of PT010 and a Single Dose of PT003 in Healthy Chinese Adult Subjects Following A Single Administrations and After Chronic Administration for [NCT03075267]Phase 196 participants (Actual)Interventional2017-04-17Completed
Open Label, Prospective Study to Evaluate the Effect of Step-up From Non-extra Fine Inhaled Corticosteroids/Long Acting Beta2 Agonist (ICS/LABA) Dry Powder Inhaler (DPI) to Extra Fine Triple Therapy With CHF5993 DPI on Airway Geometry and Lung Ventilation [NCT04876677]Phase 325 participants (Actual)Interventional2021-05-25Completed
Open-label, Randomized, 3-way Cross-over, Placebo Controlled, Single Dose Clinical Pharmacology Study in COPD Patients After Inhalation of CHF 5993 pMDI Using the Standard Actuator With or Without AeroChamber Plus Flow-Vu VHC Spacer [NCT02119234]Phase 136 participants (Actual)Interventional2014-03-31Completed
A Phase IV Investigation of Sugammadex in Outpatient Urological Procedures [NCT03138967]Phase 454 participants (Actual)Interventional2017-09-18Completed
A MULTICENTRE, RANDOMISED, DOUBLE-BLIND, ACTIVE-CONTROLLED, 3-WAY CROSS-OVER STUDY TO EVALUATE THE EFFICACY AND SAFETY OF A FREE COMBINATION OF 3 DOSES OF CHF 5259 (GLYCOPYRROLATE) PLUS FOSTER® 100/6 µg (FIXED COMBINATION OF BECLOMETHASONE DIPROPIONATE PL [NCT02127866]Phase 2211 participants (Actual)Interventional2014-04-30Completed
RETHINC: REdefining THerapy In Early COPD for the Pulmonary Trials Cooperative [NCT02867761]Phase 3780 participants (Actual)Interventional2017-08-29Completed
Glycopyrrolate Prophylaxis for Prevention of Bradyarrhythmia During Laparoscopic Cholecystectomy [NCT05997004]62 participants (Actual)Interventional2018-05-01Completed
A Phase II, Randomized, Double Blind, Double Dummy, Active-controlled, Parallel-group Study to Assess the Efficacy and Safety of HRG2005 Inhalation in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease [NCT06035393]Phase 2200 participants (Anticipated)Interventional2023-10-27Not yet recruiting
Effectiveness of Sugammadex Versus Neostigmine on Neuromuscular Reversal in Pediatric Patients Undergoing Laparoscopic Appendectomy for Acute Appendicitis: A Randomized Controlled Trial [NCT05256901]Phase 4120 participants (Anticipated)Interventional2023-07-19Recruiting
A Multinational, Multicentre, Randomised, Double Blind, Placebo-Controlled, 2-way Crossover Study to Evaluate the Efficacy and Safety of Glycopyrrolate Bromide Administered Via pMDI (CHF 5259), for the Treatment of Patients With Chronic Obstructive Pulmon [NCT02189577]Phase 2100 participants (Actual)Interventional2014-06-30Completed
Open Label, Prospective, Exploratory Study to Investigate the Effect of Inhaled CHF5993 pMDI on Central and Peripheral Airway Dimensions in COPD Patients by Functional Respiratory Imaging [NCT03268226]Phase 320 participants (Actual)Interventional2017-11-20Completed
Anticholinergic Premedication Induced Fever in Pediatric Ambulatory Anesthesia With Ketamine [NCT02430272]84 participants (Actual)Interventional2014-05-31Completed
The Use of Propofol/Ketamine Anesthesia With Bispectral Monitoring (PKA-BIS) Versus Inhalational Anesthetics in Rhytidoplasty - A Prospective, Double-blinded, Randomized Comparison Study [NCT02410460]30 participants (Actual)Interventional2013-09-30Completed
Antiperistaltic Effect and Safety of Glycopyrronium for Colonoscopic Polypectomy: a Randomized, Double-blind, Placebo-controlled Study [NCT06041984]Phase 1/Phase 2150 participants (Anticipated)Interventional2023-10-08Enrolling by invitation
Prevention of Postoperative Events Following Reversal With Sugammadex or Neostigmine [NCT02825576]Phase 430 participants (Actual)Interventional2018-12-03Terminated(stopped due to Lack of Study Personnel)
Impact of Fixed TRIple Therapy With Beclometasone/Formoterol/Glycopyrronium DPI (Trimbow® in NEXThaler Device) in Chronic Obstructive PulmoNary Disease in rEal-world Settings: Health-related Quality of Life Patient' eXpectations and characterisTics: the T [NCT05948891]500 participants (Anticipated)Observational2023-07-31Not yet recruiting
A Phase IV, Open Label, Multicentre, Randomised, 2-way Cross-over Exploratory Clinical Trial Comparing TRIMBOW® pMDI and RELVAR® ELLIPTA® DPI on Lung Stiffness Reduction Assessed Through Area Under the Reactance Curve (AX) in COPD. [NCT04671355]Phase 40 participants (Actual)Interventional2021-10-04Withdrawn(stopped due to Continuing delays due to COVID-19 pandemic)
Randomized Double Control Study to Assess the Efficacy of Administering 1 ml of Glycopyrrolate With the Spinal Dose in Minimizing Nausea and Vomiting in Patients Undergoing Cesarean Section Under Spinal Anesthesia [NCT02872935]Phase 422 participants (Actual)Interventional2015-05-15Terminated
A Phase I, Randomized, Double-Blind, Single-Dose, Three-Period, Three-Treatment, Cross-Over Study Evaluating the Pharmacokinetics and Safety of a Single Dose of PT010, a Single Dose of PT009, and a Single Dose of Open-Label Symbicort® Turbohaler® in Healt [NCT02189304]Phase 159 participants (Actual)Interventional2014-06-01Completed
Benefits of Intramuscular Glycopyrrolate Premedication on Intubation With Rigid-videostylet (OptiScope® PM 201, KoMAC Co., Ltd, Seoul, Republic of Korea) [NCT03050242]78 participants (Actual)Interventional2017-03-13Completed
A Pharmacokinetic Feasibility Study on Ultibro Breezhaler, an Indacaterol-glycopyrronium Inhalation Powder Capsule, in Healthy Subjects [NCT04856098]Phase 134 participants (Actual)Interventional2021-05-07Completed
Effect of Glycopyrronium in Combination With Tropisetron in Anti-postoperative Nausea and Vomiting [NCT05331651]Phase 4480 participants (Actual)Interventional2022-04-08Completed
A Study to Assess the Pharmacokinetics and Safety of PT010 in Subjects With Moderate to Severe COPD Following Single and Repeat Dose Administration [NCT03250182]Phase 130 participants (Actual)Interventional2017-08-11Completed
Recovery From Optimal Neuromuscular Blockade in the Critically Ill: Randomized Control Trial [NCT03791801]50 participants (Anticipated)Interventional2019-09-01Recruiting
Effect of Atropine or Glycopyrrolate on the Prevention of Bradycardia During Sedation Using Dexmedetomidine in Adult Patients Undergoing Lower Extremity Surgery Under Spinal Anesthesia [NCT03322150]2 participants (Actual)Interventional2017-10-01Terminated(stopped due to The research was terminated because the recruitment of the study subjects was not smooth and the overseas training of the investigator was scheduled.)
Effect of Perioperative Use of Glycopyrrolate on Lung Function in Patients Under General Anesthesia [NCT05693246]90 participants (Anticipated)Interventional2022-11-01Recruiting
A Multicenter, Randomized, Double-blind, Placebo-controlled 3-period Complete Cross-over Study to Assess the Bronchodilator Effects and Safety of Glycopyrronium Bromide (NVA237) (25 ug and 50 ug o.d.) in Asthma Patients. [NCT03137784]Phase 2/Phase 3148 participants (Actual)Interventional2017-05-04Completed
A 26-week Treatment, Randomized, Double-blind, Placebo-controlled, Parallel Group Study to Assess the Efficacy, Safety and Tolerability of NVA237 in Patients With Chronic Obstructive Pulmonary Disease [NCT01005901]Phase 31,324 participants (Actual)Interventional2009-10-31Completed
Effects of Long Acting Bronchodilators on CARDiac Autonomic Nervous System Control in Patients With COPD [NCT02872090]Phase 442 participants (Actual)Interventional2016-03-31Completed
A Double-Blind, Multicentre, Randomized, Three-Period, Three-Treatment, Cross-Over Study to Evaluate the Effect of BGF MDI, BFF MDI, and Placebo MDI on Exercise Parameters in Participants With COPD (ATHLOS) [NCT06067828]Phase 3180 participants (Anticipated)Interventional2023-10-24Recruiting
A Prospective Trial to Assess How Glycopyrronium Cloths at the Amputation Site of Limb Amputees Changes the Severity of Hyperhidrosis and the Fit and Function of the Prosthetic Measured by Patient Reported Outcomes [NCT04924036]Phase 220 participants (Anticipated)Interventional2021-09-27Enrolling by invitation
Duration of Bronchoprotection of the Long Acting Muscarinic Antagonists Tiotropium and Glycopyrronium Against Methacholine Induced Bronchoconstriction [NCT02622243]Phase 413 participants (Actual)Interventional2015-11-30Completed
Intranasal Administration of Neostigmine and Glycopyrrolate for Bowel Evacuation [NCT00855283]Phase 220 participants (Anticipated)Interventional2012-09-30Completed
Effect of Glycopyrrolate and Atropine as Adjuncts to Reversal of Non-Depolarizing Neuromuscular Blocking Agents on Postoperative Catheter-Related Bladder Discomfort [NCT02228473]76 participants (Anticipated)Interventional2014-09-30Recruiting
Acute Effect of Aclidinium on Hyperinflation and Lung Volume Distribution in Severe COPD Patients [NCT02181023]Phase 437 participants (Actual)Interventional2014-06-30Completed
Comparison of Atropine Versus Glycopyrrolate in Preventing Spinal Anesthesia Induced Hypotension in Adult Patient Undergoing Major Lower Limb Orthopedic Surgeries [NCT03580889]Phase 4138 participants (Anticipated)Interventional2017-09-15Recruiting
Outcomes in Real-life After Initation Of treatmeNt With Trixeo (Budesonide / Glycopyrronium / Formoterol), a Non-interventional, Multi-centre, Prospective Cohort Study in Italian Routine Care Setting [NCT05862545]250 participants (Anticipated)Observational2023-06-01Recruiting
Combined Dexmedetomidine and Glycopyrrolate Therapy for Prevention of Catheter Related Bladder Discomfort After Transurethral Bladder Surgery [NCT05013320]0 participants (Actual)Interventional2021-09-01Withdrawn(stopped due to We could not get the IRB approval)
A Randomized, Double-blind, Parallel Group, 52-week Study Evaluating the Efficacy, Safety and Tolerability of NVA237 in Patients With Poorly Controlled Asthma [NCT02127697]Phase 30 participants (Actual)Interventional2015-03-31Withdrawn
A Randomized, Phase IIIb, Three-period, Three-treatment, Double-blind, Multi-center, Crossover Study to Evaluate the 24-hour Lung Function Profile in Subjects With Moderate to Very Severe COPD After 4 Weeks of Treatment With PT003, Open-Label Spiriva® Res [NCT02347072]Phase 380 participants (Actual)Interventional2015-02-01Completed
IKANOS: A Prospective, Open-Label, Minimally Interventional Hybrid Study in the US Comparing Initiation of Breztri Maintenance Versus Any Non-Triple Inhaled Therapy at Discharge After a Hospitalization for a COPD Exacerbation [NCT05970263]Phase 41,000 participants (Anticipated)Interventional2024-01-15Not yet recruiting
A Randomized, Double-blind, Positive and Placebo-controlled, Single-dose, Crossover Study of the Effects of CHF5993 pMDI (BDP/FF/GB) at the Proposed Therapeutic and Supratherapeutic Doses, on the Cardiovascular Safety in Healthy Subjects [NCT05830071]Phase 195 participants (Actual)Interventional2023-03-29Completed
Comparison of Time to Full Recovery From Muscle Paralysis (TOF>0.9) and Extubation Using Sugammadex Versus Neostigmine/Glycopyrrolate in Patients With Pulmonary Disease in the Outpatient Bronchoscopy Suite [NCT04606901]Phase 458 participants (Actual)Interventional2021-04-08Completed
The Impact of Sugammadex on Ileus After Abdominal Wall Reconstruction [NCT05985343]Phase 4184 participants (Anticipated)Interventional2023-12-01Not yet recruiting
Safety and Efficacy of High Resolution Manometry in Studying Colonic Motility and Iontophoretic Administration of Prokinetic Agents [NCT02574611]Phase 10 participants (Actual)Interventional2015-10-13Withdrawn(stopped due to No reportable findings are possible. The PI/Co-PI were unable to recruit participants for this study. One participant was consented but did not undergo any study procedure.)
A Phase 2, Randomized, Double-blind, Vehicle-controlled Efficacy and Safety Study of Glycopyrronium Cloth, 2.4% in Patients With Palmar Hyperhidrosis [NCT03880266]Phase 272 participants (Actual)Interventional2019-02-22Completed
The Effectiveness of Single Dose Ultibro Breezhaler (Indacaterol/Glycopyrronium) by Sd-DPI Versus Ipratropium/Salbutamol by Nebulizer in Improving FEV1 and Dyspnea During Stable State of COPD [NCT02576626]Phase 440 participants (Actual)Interventional2015-12-31Completed
A Randomized, Double-blind, Placebo-controlled, 4 Period Incomplete Block Cross-over, Multi-center, Multiple Dose (7 Days) Dose-ranging Study to Assess the Efficacy and Safety of 4 Doses of NVA237 in Patients With Stable COPD, Compared to Seven Days Treat [NCT00501852]Phase 283 participants (Actual)Interventional2007-07-31Completed
A Six-Month, Multi-Center, Open-Label Study to Assess the Safety and Efficacy of Oral Glycopyrrolate Liquid for the Treatment of Pathologic (Chronic Moderate to Severe) Drooling in Pediatric Patients 3 to 18 Years of Age With Cerebral Palsy or Other Neuro [NCT00491894]Phase 3137 participants (Actual)Interventional2007-03-31Completed
A Feasibility Study of Glycopyrrolate in Comparison to Hyoscine Hydrobromide and Placebo in the Treatment of Hypersalivation Induced by Clozapine [NCT02613494]Phase 1/Phase 229 participants (Actual)Interventional2016-01-25Completed
An Open-label, Uncontrolled, Multicenter Study to Evaluate the Safety, Local Tolerability, Systemic Exposure, and Efficacy of 1% Glycopyrronium Bromide (GPB) Cream in Adolescents With Severe Primary Axillary Hyperhidrosis [NCT05863104]Phase 240 participants (Anticipated)Interventional2023-03-07Recruiting
A Randomized, Double-blind, Placebo Controlled, Multicentre Study to Determine the Effect of QVA149 on Lung Function in Patients With Chronic Obstructive Pulmonary Disease (COPD) [NCT00570778]Phase 2154 participants (Actual)Interventional2007-12-31Completed
Randomized Controlled Assessor Blinded Clinical Trial of Sugammadex Versus Neostigmine /Glycopyrrolate for Reversal of Rocuronium Induced Neuromuscular Blockade: Time to Discharge From Post Anesthesia Care Unit and Patient Satisfaction With Recovery [NCT03116997]Phase 3201 participants (Actual)Interventional2017-04-07Completed
A Phase 4 Double-blinded, Randomized, Active Comparator-controlled Clinical Trial to Study the Efficacy, Safety, and Pharmacokinetics of Sugammadex (MK-8616) for Reversal of Neuromuscular Blockade in Pediatric Participants Aged Birth to <2 Years [NCT03909165]Phase 4137 participants (Actual)Interventional2019-07-23Completed
Intraoperative Video Laryngoscopy as Adjunct for Nerve Monitoring [NCT03742141]125 participants (Actual)Interventional2018-10-17Completed
Indacaterol 110µg/ Glycopyrronium 50µg (Ultibro®) Versus Tiotropium (Spiriva®) Alone to Reduce Exertional Dyspnea in Patients With Moderate to Severe COPD [NCT02567214]Phase 450 participants (Actual)Interventional2016-06-30Completed
A Randomized, Double-blind, Placebo-controlled, 2-period, Cross-over Study to Assess the Efficacy and Safety of Differing Doses of NVA237 Administered Either Once Daily or Twice Daily, in Patients With Moderate to Severe Chronic Obstructive Pulmonary Dise [NCT01119950]Phase 2388 participants (Actual)Interventional2010-04-30Completed
Open-label, Randomized, Single-dose, Placebo-controlled, 4-way Crossover Study to Investigate the Pharmacokinetic Interaction of Glycopyrrolate and Formoterol in Healthy Subjects. [NCT01398111]Phase 144 participants (Actual)Interventional2011-05-31Completed
A Randomised, Single Blind, Cross-over Study to Compare a Fixed Dose Combination of Fluticasone Propionate / Formoterol Fumarate (Breath Actuated Inhaler (BAI)) With a Fixed Dose Combination of Indacaterol Maleate / Glycopyrronium Bromide (Ultibro® Breezh [NCT02693769]Phase 2/Phase 32 participants (Actual)Interventional2016-07-31Terminated(stopped due to Recruitment issues)
Open-label, Non-randomized, Parallel-group Study to Investigate the Pharmacokinetics, Safety and Tolerability of a Single Dose of CHF 5993 pMDI in Subjects With Mild, Moderate and Severe Renal Impairment in Comparison With Matched Healthy Control Subjects [NCT02040597]Phase 142 participants (Actual)Interventional2014-01-31Completed
A Multi-Center, Randomized, Double-Blind, Parallel-Group Study to Investigate the Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Multiple Inhaled NVA237 Doses at Four Dose Levels in COPD Patients [NCT00545311]Phase 140 participants (Actual)Interventional2007-07-31Completed
A Multi -Center Randomized Parallel Group Comparative Active Controlled Safety Assessor Blinded Phase 3a Pivotal Trial in Adult Subjects Comparing Org 25969 With Neostigmine as Reversal Agents of a Neuromuscular Block Induced by Rocuronium or Vecuronium a [NCT00451217]Phase 3198 participants (Actual)Interventional2005-11-17Completed
"Low Dose Sugammadex Combined With Neostigmine and Glycopyrrolate Versus Full Dose Sugammadex for Reversal of Rocuronium-induced Neuromuscular Blockade: a Cost Saving Strategy" [NCT02375217]Phase 456 participants (Actual)Interventional2014-10-31Completed
A Phase 3 Randomised Double Blind Randomised Parallel Multinational Trial Comparing a Fixed Combination of Beclometasone+Formoterol+Glycopyrrolate to Foster® in Patients With Chronic Obstructive Pulmonary Disease [NCT01917331]Phase 31,368 participants (Actual)Interventional2014-03-31Completed
A Randomized, Blinded, Double Dummy, Multi-center, Placebo Controlled, 3 Period, Crossover Study to Assess the Effect of QVA149 (110/50 µg o.d.) on Exercise Endurance in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD), Using [NCT01294787]Phase 385 participants (Actual)Interventional2011-02-28Completed
A Multicenter, Randomized, Parallel Group Comparative, Active-Controlled, Safety-assessor Blinded. Phase IIIa, Pivotal Trial in Adult Subjects Comparing Org 25969 With Neostigmine as Reversal Agent of a Neuromuscular Block Induced by Maintenance Dosing of [NCT00473694]Phase 3182 participants (Actual)Interventional2005-11-28Completed
A 52-week Treatment, Multi-center, Randomized, Open Label, Parallel Group Study to Assess the Long Term Safety and Tolerability of NVA237 (50µg o.d.) Using Tiotropium (18µg o.d.) as an Active Control in Japanese Patients With Moderate to Severe Chronic Ob [NCT01119937]Phase 3211 participants (Actual)Interventional2010-05-31Completed
A 26-week Treatment Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled (Open Label) Study to Assess the Efficacy, Safety and Tolerability of QVA149 (110/50 μg q.d.) in Patients With Moderate to Severe Chronic Obstructive [NCT01202188]Phase 32,144 participants (Actual)Interventional2010-09-30Completed
Effect of Glycopyrrolate on Nausea and Vomiting After ERCP Operation [NCT06045364]Phase 1/Phase 2130 participants (Anticipated)Interventional2023-10-01Not yet recruiting
Pharmacokinetics of Neostigmine and Glycopyrrolate After Intravenous and Transcutaneous Administration by Iontophoresis [NCT04027972]Early Phase 113 participants (Actual)Interventional2020-03-09Active, not recruiting
A Randomized, Double-blind, Placebo-controlled, Multi-center, Two-period Crossover Study to Investigate the Bronchodilatory Effect of 50 µg NVA237 Inhaled Once Daily in Patient With Chronic Obstructive Pulmonary Disease (COPD). [NCT00856193]Phase 233 participants (Actual)Interventional2009-02-28Completed
A Randomized, Open-Label, Multiple Dose, Two-Period Crossover Study Evaluating Maximum Use 1% GPB Cream Versus Qbrexza® (Glycopyrronium) Cloth 2.4% in Men and Women With Primary Axillary Hyperhidrosis [NCT04159610]Phase 212 participants (Anticipated)Interventional2022-07-01Not yet recruiting
A Real-world, Multicenter, 52-week Prospective Cohort Study to Capture the Reasons for Switch to Triple Combination Therapy and to Assess the Clinical and Patient Reported Outcomes in Adults With Moderate to Severe COPD Treated With Trixeo Aerosphere™ in [NCT05915182]200 participants (Anticipated)Observational2023-07-21Recruiting
A 52-week Treatment, Randomized, Double-blind, Placebo-controlled, With Open-label Tiotropium, Parallel-group Study to Assess the Efficacy, Safety, and Tolerability of Glycopyrronium Bromide (NVA237) in Patients With Chronic Obstructive Pulmonary Disease [NCT00929110]Phase 31,066 participants (Actual)Interventional2009-06-30Completed
A 64-week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Active Controlled Study to Evaluate the Effect of QVA149 (110/50 μg o.d.) vs NVA237 (50 μg o.d.) and Open-label Tiotropium (18 μg o.d.) on COPD Exacerbations in Patients With Sev [NCT01120691]Phase 32,224 participants (Actual)Interventional2010-04-30Completed
Enhanced Recovery After Surgery in Elderly Patients: Effects of Sugammadex on Recovery After Anterior Cervical Spine Surgery [NCT04161508]100 participants (Anticipated)Interventional2019-12-20Not yet recruiting
Postoperative Urinary Retention in Patients After Noncardiac Surgery and Reversal of Neuromuscular Block by Neostigmine or Sugammadex: A Randomized Controlled Trial [NCT05545280]Phase 4286 participants (Anticipated)Interventional2023-07-31Recruiting
Effect of Sugammadex Compared With Usual Care for Reversal of Neuromuscular Blockade Induced by Rocuronium on Incidence of Residual Blockade at PACU Entry [NCT01479764]Phase 3154 participants (Actual)Interventional2011-12-02Completed
A Prospective Non-interventional Study in Patients With Chronic Obstructive Pulmonary Disease That Evolve to Fixed Long-acting Muscarinic Antagonist/Long-acting beta2-agonist/Inhaled Corticosteroid Triple Therapy, Trimbow® [NCT03627858]149 participants (Actual)Observational2018-08-01Completed
Comparison of Anti-nausea and Vomiting Effect After Elective Surgery Undergoing General Anesthesia Between Glycopyrronium and Ondansetron: a Multi-center Study [NCT05265507]Phase 4480 participants (Anticipated)Interventional2022-03-21Recruiting
An Investigator Initiated, Randomized, Double Blind, Placebo Controlled Study to Assess the Effect of Glycopyrrolate/Formoterol on Exercise Tolerance and Dynamic Hyperinflation in Patients With Chronic Obstructive Pulmonary Disease. [NCT03081156]Phase 452 participants (Actual)Interventional2017-03-27Completed
A Randomized, Double Blind, Placebo Controlled, Multicenter Study to Determine the Effect of QVA149 on Mean 24-hours Heart Rate in Patients With Chronic Obstructive Pulmonary Disease (COPD) [NCT00558285]Phase 2257 participants (Actual)Interventional2007-11-30Completed
A Randomized, Double-blind, Active-controlled, Cross-over Study to Assess Efficacy and Safety of 3 Free Doses of Glycopyrrolate With Beclomethasone/Formoterol pMDI for the Treatment of COPD Patients [NCT01476813]Phase 2281 participants (Actual)Interventional2012-03-31Completed
[NCT01768780]58 participants (Anticipated)Interventional2012-12-31Recruiting
Role of Sugammadex as Reversal Agent in Patients Extubated Immediately After Isolated Coronary Artery Bypass Grafting Surgery [NCT03939923]Phase 484 participants (Actual)Interventional2019-05-01Completed
A Multi-center, Randomized, Double-blind, Placebo-controlled, Two-period Cross-over Study to Assess the Effect of 50µg Inhaled NVA237 on Exercise Endurance in Patients With Moderate to Severe COPD [NCT01154127]Phase 3108 participants (Actual)Interventional2010-06-30Completed
A 26-week Treatment, Multi-center, Randomized, Doubleblind, Double Dummy, Parallel-group Study to Assess the Efficacy, Safety and Tolerability of QVA149 Compared to Fluticasone/Salmeterol in Patients With Moderate to Severe Chronic Obstructive Pulmonary D [NCT01315249]Phase 3523 participants (Actual)Interventional2011-03-31Completed
The Effect of Glycopyrronium and Indacaterol, as Monotherapy and in Combination, on the Methacholine Dose-response Curve [NCT02953041]Phase 431 participants (Actual)Interventional2016-10-31Completed
A Phase 2, Randomized, Double-Blind, Vehicle Controlled, Dose-Ranging Study of the Effect of Glycopyrrolate in Subjects With Axillary Hyperhidrosis [NCT02016885]Phase 2198 participants (Actual)Interventional2013-11-30Completed
Decision Support for Intraoperative Low Blood Pressure [NCT02726620]22,435 participants (Actual)Interventional2017-01-05Completed
A 52-week Treatment, Multi-center, Randomized, Open Label, Parallel Group Study to Assess the Efficacy of NVA237 (50 μg o.d.) Using Tiotropium (5 μg o.d.) as an Active Control in Brazilian Patients With Moderate to Severe Chronic Obstructive Pulmonary Dis [NCT01837927]Phase 30 participants (Actual)Interventional2014-04-30Withdrawn
A Phase III, 52-week, Multinational, Multicenter, Randomized, Double-blind, 2-arm Parallel Group Study Comparing Efficacy, Safety and Tolerability of the Fixed Dose Triple Combination of Beclomethasone Dipropionate Plus Formoterol Fumarate Plus Glycopyrro [NCT04320342]Phase 32,934 participants (Anticipated)Interventional2022-04-28Recruiting
An Open-label Study Assessing Long-term Safety of Glycopyrronium in Subjects With Primary Axillary Hyperhidrosis [NCT02553798]Phase 3564 participants (Actual)Interventional2015-08-31Completed
The Off Label Use of Glycopyrrolate in the Adults Intensive Care Unit. [NCT04554589]Phase 180 participants (Anticipated)Interventional2020-09-14Not yet recruiting
A Pilot Study to Measure and Treat Antidepressant-Induced Excessive Sweating With Glycopyrrolate (AIDES-G) [NCT01588717]Phase 15 participants (Actual)Interventional2012-04-30Terminated(stopped due to PI left institution)
A Phase II, Double-blind, Randomized, Multiple Dose, Cross Over, Three-treatment, Three-period, Six Sequence Placebo Controlled Trial to Evaluate Efficacy, Pharmacokinetics (PK), Pharmacodynamics (PD) and Safety and Tolerability of Glycopyrronium (Bromide [NCT05222529]Phase 242 participants (Anticipated)Interventional2022-08-29Recruiting
Comparison of Rocuronium and Org25969 With Cisatracurium and Neostigmine When Neuromuscular Block is Reversed at Reappearance of T2 [NCT00451100]Phase 384 participants (Actual)Interventional2005-11-10Completed
Echocardiographic Study of the Haemodynamic Effects of Remifentanil With and Without Glycopyrrolate in Healthy Children [NCT00315536]Phase 263 participants (Actual)Interventional2006-05-31Completed
An Investigation of the Efficacy, Tolerability and Safety of a Range of Doses of Orally Inhaled Glycopyrronium Bromide (PSX1002-GB pMDI) in Male and Female Patients With Moderate or Severe Chronic Obstructive Pulmonary Disease [NCT01703624]Phase 237 participants (Actual)Interventional2013-05-31Completed
A 26-week Multi-center Randomized Double-blind Study to Compare Efficacy and Safety of NVA237 Versus Placebo as an add-on to Maintenance Therapy With Fixed-dose Combination Salmeterol/Fluticasone Propionate in COPD Patients With Moderate to Severe Airflow [NCT01757015]Phase 30 participants (Actual)Interventional2013-04-30Withdrawn
Effect of Glycopyrrolate on Vasopressors Requirement for Non-elective Caesarean Section Under Spinal Anaesthesia [NCT04401345]Phase 4258 participants (Actual)Interventional2020-06-01Completed
Effectiveness of Atropine and Glycopyrrolate to Reduce Hyper Salivation With Ketamine Sedation [NCT01191398]52 participants (Actual)Interventional2010-06-30Completed
A Randomized, Double-Blind, Chronic-Dosing (14 Days), 5-Period, 7-Treatment, Placebo-Controlled, Incomplete Block, Cross-Over, Multicenter, Dose-ranging Study to Assess the Efficacy and Safety of PT001 Relative to Placebo Metered Dose Inhaler and Open-Lab [NCT02433834]Phase 2248 participants (Actual)Interventional2015-05-27Completed
Pharmacokinetic Formulation Feasibility Study to Compare Relative Bioavailability of 3 Indacaterol/Glycopyrronium Easyhaler Test Products and Reference Product Ultibro Breezhaler [NCT05288075]Phase 124 participants (Actual)Interventional2022-02-28Completed
Patient-controlled Sedation With Propofol Versus Combined Sedation During Bronchoscopy - a Randomized Controlled Trial [NCT03357393]150 participants (Actual)Interventional2016-04-04Completed
Impact of Inhaled PT003 on Complexity and Variability of Tidal Breathing and Oscillatory Mechanics in Stable COPD Patient [NCT04087590]Phase 235 participants (Anticipated)Interventional2020-01-14Recruiting
Open Label, Uncontrolled, Non-randomized, Single Dose, Scintigraphic Study to Investigate Lung Deposition of Inhaled 99mTc Radiolabelled CHF5993 pMDI in Healthy Volunteers, Asthmatic and COPD Patients [NCT02975843]Phase 128 participants (Actual)Interventional2016-11-21Completed
A Multi-center, Randomized, Double-blind, 52-week Study to Assess the Safety of NVA237 Compared to QAB149 in Patients With Chronic Obstructive Pulmonary Disease (COPD) Who Have Moderate to Severe Airflow Limitation [NCT01697696]Phase 3511 participants (Actual)Interventional2012-10-31Completed
A 26-week Treatment, Multicenter, Randomized, Parallel Group, Blinded Study to Assess the Efficacy and Safety of QVA149 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease Using Tiotropium Plus Formoterol as Control [NCT01574651]Phase 3934 participants (Actual)Interventional2012-05-31Completed
Sugammadex Versus Neostigmine for Reversal of Rocuronium-induced Neuromuscular Blockade: A Study of Thoracic Surgical Patients [NCT03168308]Phase 492 participants (Actual)Interventional2017-09-26Completed
Use of Sugammadex for Reversal of Paralysis in Microlaryngoscopy [NCT03111121]Phase 484 participants (Anticipated)Interventional2017-05-04Recruiting
A Randomised, Placebo-Controlled, Double-Blind, Multi-Centre, 4-week, 3-way Crossover Pharmacodynamic Study to Assess the Equivalence of Budesonide, Glycopyrronium, and Formoterol Fumarate (BGF) Delivered by MDI HFO Compared With BGF Delivered by MDI HFA [NCT06075095]Phase 3240 participants (Anticipated)Interventional2024-01-15Not yet recruiting
Effect of Deep Curarisation and Reversal With Sugammadex on Surgical Conditions and Perioperative Morbidity in Patients Undergoing Laparoscopic Gastric Bypass Surgery [NCT01748643]Phase 460 participants (Actual)Interventional2013-04-30Completed
A Multicenter, Randomized, Double-blind, Single-dose Study to Assess the Effect of the QAB149 and NVA237 Combination Versus QAB149 Alone on Inspiratory Capacity in Patients With Moderate or Severe COPD. [NCT01699685]Phase 379 participants (Actual)Interventional2012-11-30Completed
A Randomized, Double-blind, Parallel Group, 26-week Study Evaluating the Efficacy, Safety and Tolerability of NVA237 Given Once or Twice Daily, in Patients With Moderate and Severe Chronic Obstructive Pulmonary Disease [NCT02371629]Phase 4776 participants (Actual)Interventional2015-06-24Completed
An Open Label, Non-randomized, Parallel-group Study to Characterize and Compare the Pharmacokinetics, Safety, and Tolerability of a Single Dose of NVA237 in Subjects With Mild, Moderate, Severe and End-stage Renal Impairment With That in Matched Healthy C [NCT01613690]Phase 148 participants (Actual)Interventional2010-06-30Completed
Street Fitness in Surgical Patients Undergoing General Anesthesia After Reversal of Neuromuscular Rest Blockade With Sugammadex [NCT01453530]Phase 430 participants (Anticipated)Interventional2011-10-31Recruiting
A Randomized, Parallel-group, Open-label Study to Evaluate the Efficacy and Safety of Umeclidinium (UMEC) 62.5 mcg Compared With Glycopyrronium 44 mcg in Subjects With Chronic Obstructive Pulmonary Disease (COPD) [NCT02236611]Phase 41,036 participants (Actual)Interventional2014-09-26Completed
Determinants of Chronotropic Incompetence in Patients With Heart Failure and a Preserved Ejection Fraction (HFpEF) [NCT02524145]40 participants (Actual)Interventional2015-06-30Completed
A Prospective, Multicenter, 12-week, Randomized Open-label Study to Evaluate the Efficacy and Safety of Glycopyrronium (50 Micrograms o.d.) or Indacaterol Maleate and Glycopyrronium Bromide Fixed-dose Combination (110/50 Micrograms o.d.) Regarding Symptom [NCT01985334]Phase 44,389 participants (Actual)Interventional2014-02-14Completed
Multicenter, Randomized, Blinded, Two-period Cross-over Study to Assess the Effect of Glycopyrronium (44 Micrograms QD) Versus Tiotropium (18 Micrograms QD) on Morning Symptoms and Pulmonary Function in Patients With Moderate to Severe COPD [NCT01959516]Phase 4124 participants (Actual)Interventional2014-02-28Completed
A Randomized, Phase IIIb, Two-period, Two-treatment Double-blind, Multi-center, Crossover Study to Evaluate the 24-hour Lung Function Profile in Subjects With Moderate to Very Severe COPD After 4 Weeks of Treatment With PT003 and Placebo MDI [NCT02347085]Phase 343 participants (Actual)Interventional2015-02-01Completed
An Open-Label, Multi-Center, Dose Indicator Study of Glycopyrronium and Formoterol Fumarate (GFF) Metered Dose Inhaler (MDI) in Adult Subjects With Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD) [NCT02268396]Phase 3138 participants (Actual)Interventional2014-11-30Completed
Spinal Versus General Anesthesia With Popliteal and Adductor Canal Blocks for Ambulatory Foot and Ankle Surgery: A Double-Blinded Randomized Controlled Trial. [NCT02996591]Phase 436 participants (Actual)Interventional2017-01-31Completed
A Phase I, Randomized, Double-Blind, Single-Dose, Four-Period, Four-Treatment, Cross-Over Study Evaluating the Safety and Pharmacokinetics of Two Doses of PT003 and Two Doses of PT001 in Japanese Healthy Subjects [NCT02196714]Phase 124 participants (Actual)Interventional2014-07-31Completed
Non-inferiority Evaluation of Trimbow in Critically Ill Patients Admitted in ICU Compared to Standard of Care [NCT04737655]Phase 4200 participants (Anticipated)Interventional2021-02-15Not yet recruiting
Single-dose, Dose Escalation Study to Assess the Safety, Tolerability, Pharmacokinetics and Bronchodilatory Effects of Glycopyrrolate Inhalation Solution (GIS) Using a High Efficiency Nebulizer in Patients With COPD [NCT02951312]Phase 212 participants (Actual)Interventional2009-05-31Completed
A Randomized, Blinded-assessor, Single Center Study to Determine if Administration of Sugammadex, When Used to Reverse Deep Neuromuscular Blockade (NMB) After Open Abdominal Surgery, Impacts Hospital Efficiency [NCT02860507]Phase 450 participants (Actual)Interventional2016-08-31Completed
Open Label, Uncontrolled, Non-randomized, Single Dose, Scintigraphic Study to Investigate Lung Deposition of Inhaled 99mTc Radiolabelled TRIMBOW® pMDI in Healthy Volunteers, Asthmatic and COPD Patients [NCT03795350]Phase 119 participants (Actual)Interventional2019-01-14Terminated(stopped due to In light of the cessation of non-essential clinical activities at CPU due to the COVID-19 pandemic, the sponsor has determined to terminate the study early.)
Sugammadex Versus Neostigmine for Reversal of Rocuronium Neuromuscular Block in Patients Having Catheter-based Neurointerventional Procedures [NCT03322657]Phase 469 participants (Actual)Interventional2017-11-14Completed
An Observer-blinded Randomized Study of Propofol Infusion vs Bolus Dexmedetomidine and Propofol Sedation for Pediatric Magnetic Resonance Imaging [NCT03513757]Phase 440 participants (Actual)Interventional2018-03-04Completed
A Randomized, Placebo-controlled, 2-arm Parallel-group Superiority Phase II Study of GLYCOpyrrolate for Moderate-to-severe Sialorrhea in PARkinson's Disease [NCT02382198]Phase 228 participants (Anticipated)Interventional2016-07-31Recruiting
A Randomized, Multicenter, Open-label, Parallel-group, 12-week Study to Assess the Efficacy and Safety of Switching From Tiotropium to QVA149 (Indacaterol Maleate/Glycopyrronium Bromide) in Symptomatic Mild to Moderate COPD Patients [NCT02566031]Phase 4379 participants (Actual)Interventional2013-03-23Completed
[NCT02370433]Phase 120 participants (Anticipated)Interventional2012-12-31Recruiting
Intraoperative Lidocaine Infusion vs. Esmolol Infusion for Postoperative Analgesia in Laparoscopic Cholecystectomy: a Randomized Clinical Trial [NCT02327923]Phase 490 participants (Actual)Interventional2015-01-31Completed
A Multicenter, Randomized, Blinded, Double-dummy, Placebo-controlled, 3-period Cross-over Study to Evaluate the Effect of QVA149 on Patient Reported Dyspnea in Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD), Using Tiotropium as an Active [NCT01490125]Phase 3247 participants (Actual)Interventional2011-10-31Completed
A Multicenter, Randomized, Blinded, Active-controlled, Parallel-group Study to Compare the Efficacy, Tolerability and Safety of NVA237 Compared to Tiotropium Added on to Fluticasone/Salmeterol in Patients With Chronic Obstructive Pulmonary Disease [NCT01513460]Phase 3773 participants (Actual)Interventional2012-04-30Completed
A Multi-center, Randomized, Double-blind, Double-dummy, Active Controlled, Two-period Cross-over Study to Assess the Efficacy, Safety and Tolerability of Indacaterol Maleate/Glycopyrronium Bromide Compared to Umeclidinium Bromide/Vilanterol in COPD Patien [NCT02487498]Phase 3355 participants (Actual)Interventional2015-07-27Completed
A Phase 3, Randomized, Double-Blind, Vehicle-Controlled Efficacy and Safety Study of Glycopyrronium in Subjects With Axillary Hyperhydrosis [NCT02530281]Phase 3344 participants (Actual)Interventional2015-07-31Completed
Xenon MRI Probing vEntilation Response to Triple Therapy (QVM149) [NCT04206761]Phase 30 participants (Actual)Interventional2021-12-01Withdrawn(stopped due to issues related to Covid-19 restrictions/shutdowns)
Comparison of Reversal of Neuromuscular Blockade With Sugammadex Versus Neostigmine Plus Glycopyrolate in Patients Undergoing Burn Surgery [NCT03513406]Phase 37 participants (Actual)Interventional2018-03-15Completed
A Randomized, Open-Label, Active-Controlled, Parallel-Group, Multicenter, Long-Term Safety Trial of Treatment With Nebulized SUN-101 in Patients With COPD: GOLDEN-5 (Glycopyrrolate for Obstructive Lung Disease Via Electronic Nebulizer) [NCT02276222]Phase 31,087 participants (Actual)Interventional2014-10-31Completed
A Multi-centre Randomized Double Blind 52-week Study to Assess the Safety of QVA149 Compared to QAB149 in Patients With COPD Who Have Moderate to Severe Airflow Limitation [NCT01682863]Phase 3614 participants (Actual)Interventional2012-10-31Completed
A Study to Compare the Efficacy and Safety of Once Daily QVA149 Versus the Once Daily Concurrent Administration of QAB149 Plus NVA237 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease [NCT01529632]Phase 3193 participants (Actual)Interventional2012-05-31Completed
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 Airf [NCT01712516]Phase 31,001 participants (Actual)Interventional2012-12-31Completed
A 12-week Multi-center, Randomized, Double-blind, Placebo Controlled Study to Assess the Efficacy and Safety of NVA237 in Stable COPD Patients [NCT01709864]Phase 3440 participants (Actual)Interventional2012-11-30Completed
Effect of Atropine or Glycopyrrolate on the Prevention of Bradycardia During Sedation Using Dexmedetomidine in Geriatric Patients Undergoing Total Knee Replacement Under Spinal Anesthesia [NCT03322098]54 participants (Actual)Interventional2017-10-16Completed
An Open-label Study to Evaluate the Efficacy and Safety of Different Methods of Application of Glycopyrronium Cloth, 2.4% in Patients With Palmar Hyperhidrosis [NCT04906655]Phase 2120 participants (Actual)Interventional2020-10-01Completed
A 12-week Multi-center, Randomized, Double-blind, Placebo Controlled Study to Assess the Efficacy and Safety of NVA237 in Stable COPD Patients [NCT01715298]Phase 3432 participants (Actual)Interventional2012-11-30Completed
A Phase 2, Randomized, Double-Blind Vehicle-Controlled Comparator Study of the Effect of Glycopyrrolate and Glycopyrronium in Subjects With Axillary Hyperhidrosis [NCT02129660]Phase 2105 participants (Actual)Interventional2014-04-30Completed
Effect of Anesthetic Choice (Sevoflurane Versus Desflurane) on Speed and Sustained Nature of Airway Reflex Recovery in the Context of Antagonized Neuromuscular Block [NCT01199237]Phase 4107 participants (Actual)Interventional2010-08-31Completed
A Crossover Clinical Pharmacology Study to Evaluate the Total Systemic Exposure and Lung Bioavailability of SUN-101 and Seebri® Breezhaler® Administered With and Without Activated Charcoal in Subjects With Moderate to Severe Chronic Obstructive Pulmonary [NCT02512302]Phase 130 participants (Actual)Interventional2015-10-31Completed
A Randomized, Controlled, Parallel-group, Double-blind Trial of Sugammadex or Usual Care (Neostigmine or Spontaneous Recovery) for Reversal of Rocuronium- or Vecuronium-induced Neuromuscular Blockade in Patients Receiving Thromboprophylaxis and Undergoing [NCT01422304]Phase 31,198 participants (Actual)Interventional2011-10-12Completed
Effects of the Addition of a Prokinetic Agent to Thrice Weekly Bowel Care in Individuals With SCI [NCT04671030]Phase 16 participants (Actual)Interventional2018-01-15Completed
A Multi-center, Randomized, Double-blind, Double-dummy, Active Controlled, 2-period Cross-over Study to Assess the Efficacy, Safety and Tolerability of Indacaterol Maleate/Glycopyrronium Bromide Compared to Umeclidinium Bromide/Vilanterol in COPD Patients [NCT02487446]Phase 3357 participants (Actual)Interventional2015-07-28Completed
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 Airf [NCT01727141]Phase 31,042 participants (Actual)Interventional2012-11-30Completed
Sugammadex Reversal VS Neostigmine and Glycopyrrolate Competitive Antagonism of Neuromuscular Blockade for GI-2 Recovery After Bowel Resection: Prospective, Randomized, Triple-blinded Clinical Trial for Quality Improvement [NCT06112353]Phase 4128 participants (Anticipated)Interventional2023-11-30Not yet recruiting
A Multicentre, Randomised, Double-blind, Placebo-controlled, 2-way Cross-over Study to Evaluate the Efficacy and Safety of CHF 5259 (Glycopyrrolate Bromide) pMDI on Top of QVAR® pMDI for the Treatment of Patients With Uncontrolled Asthma on Low-Medium Dos [NCT02296411]Phase 298 participants (Actual)Interventional2014-11-30Completed
Prospective Cohort Study for the Real - Life Effectiveness Evaluation of GlycOpyrronium With IndacatERol Combination in the Management of COPD in Canada (POWER Study) [NCT02202616]Phase 4401 participants (Actual)Interventional2014-08-27Completed
Randomized, Open-label, Three Arms Study to Evaluate the Efficacy of Inhaled Therapies in the Treatment of Acute Symptoms Associated With COVID-19 and in the Prevention of the Use of Health Resources in Patients With ≥ 18 Years Old (TRIVID Study) [NCT04937543]Phase 250 participants (Actual)Interventional2021-06-28Active, not recruiting
A Randomized, Double-Blind, Chronic Dosing (24 Weeks), Placebo-Controlled, Parallel Group, Multi-Center Study to Assess the Efficacy and Safety of PT003, PT005, and PT001 in Subjects With Moderate to Very Severe COPD, Compared With Placebo [NCT02343458]Phase 31,756 participants (Actual)Interventional2015-03-30Completed
A Double-blind, Randomized, Parallel Group Study to Compare Rocuronium Reversal With Sugammadex (Bridion®) Versus Neostigmine/Glycopyrrolate and the Incidence of Urinary Retention After Elective Ambulatory Posterior Lumbar Laminectomy [NCT05887375]Phase 4118 participants (Anticipated)Interventional2023-08-03Enrolling by invitation
A Randomized, Double-Blind (Test Products and Placebo), Chronic Dosing (24 Weeks), Placebo-Controlled, Parallel Group, Multi-Center Study to Assess the Efficacy and Safety of PT003, PT005, and PT001 in Subjects With Moderate to Very Severe COPD, Compared [NCT01854658]Phase 31,615 participants (Actual)Interventional2013-07-31Completed
Utilizing Wearable Device to Observe the Clinical Response of COPD Patients Treated With Combined Bronchodilator and Home-based Pulmonary Rehabilitation Program [NCT03364829]Phase 450 participants (Anticipated)Interventional2016-01-01Recruiting
A 26-week Treatment Randomized, Double-blind, Double Dummy, Parallel-group Study to Assess the Efficacy and Safety of QVA149 (Indacaterol / Glycopyrronium Bromide) Compared to Fluticasone/Salmeterol in Patients With Moderate to Severe COPD [NCT01709903]Phase 3744 participants (Actual)Interventional2012-11-30Completed
A Randomized Clinical Study to Compare Low Dose of Sugammadex to Standard Dose of Neostigmine and Glycopyrrolate for the Reversal of Rocuronium Induced Moderate Neuromuscular Block [NCT05718934]Phase 4144 participants (Anticipated)Interventional2022-11-08Recruiting
A Phase 3, Randomized, Double-blind, Vehicle-controlled Efficacy and Safety Study of Glycopyrronium in Subjects With Axillary Hyperhidrosis [NCT02530294]Phase 3353 participants (Actual)Interventional2015-08-31Completed
A 12-week Treatment, Randomized, Blinded, Double-dummy, Parallel-group Study to Assess the Efficacy, Safety, and Tolerability of NVA237 (50 µg o.d.) Compared to Tiotropium (18 µg o.d.) in Patients With Chronic Obstructive Pulmonary Disease (COPD) [NCT01613326]Phase 3657 participants (Actual)Interventional2012-06-30Completed
A Multicenter, 4-week Crossover (Total Duration 12 Weeks), Placebo-controlled, Double-blind Study to Determine the Impact of QVA149 (Indacaterol/Glycopyrronium) 85/43 µg on Nocturnal Oxygen Levels in Chronic Obstructive Pulmonary Disease (COPD) [NCT02233543]Phase 438 participants (Actual)Interventional2014-11-30Completed
A 12-week Multi-center, Randomized, Double-blind, Parallel Group Study to Assess the Efficacy, Safety and Tolerability of the Co-administration of NVA237 + Indacaterol Once Daily vs. Indacaterol Once Daily in Patients With Moderate to Severe COPD [NCT01604278]Phase 3449 participants (Actual)Interventional2012-05-31Completed
A Randomized, Double-blind, Multicenter, 2-period Single-dose Cross-over Study to Assess the Early Bronchodilation of Glycopyrronium Bromide (44 μg o.d.) Compared to Tiotropium (18 µg. o.d.) in Patients With Moderate to Severe COPD (FAST Study) [NCT01922271]Phase 4152 participants (Actual)Interventional2013-08-31Completed
A 26-week Treatment, Randomised, Double-blind, Placebo-controlled, Parallel Group Study to Assess the Efficacy, Safety and Tolerability of NVA237 (50 µg o.d.) in Patients With Chronic Obstructive Pulmonary Disease [NCT01566604]Phase 3460 participants (Actual)Interventional2012-03-31Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT00451217 (5) [back to overview]Number of Participants With Clinical Signs of Recovery Assessed by Level of Consciousness, Head Lift and Muscle Weakness, Prior to Transfer to the Recovery Room After Extubation
NCT00451217 (5) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8
NCT00451217 (5) [back to overview]Number of Participants With Clinical Signs of Recovery Assessed by Level of Consciousness, Head Lift and Muscle Weakness, Prior to Discharge From the Recovery Room
NCT00451217 (5) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the Fourth Twitch/First Twitch (T4/T1) Ratio to 0.9.
NCT00451217 (5) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.9 After Neuromuscular Block (NMB) Induced by Vecuronium
NCT00473694 (11) [back to overview]Number of Participants Able to Perform a 5-second Head Lift
NCT00473694 (11) [back to overview]Number of Participants Aroused With Minimal Stimulation After Anesthesia (Clinical Assessment of Level of Consciousness)
NCT00473694 (11) [back to overview]Number of Participants Responsive Only to Tactile Stimulation After Anesthesia (Clinical Assessment of Level of Consciousness)
NCT00473694 (11) [back to overview]Number of Participants Awake and Oriented After Anesthesia (Clinical Assessment of Level of Consciousness)
NCT00473694 (11) [back to overview]Number of Participants Experiencing General Muscle Weakness
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7 After Neuromuscular Block (NMB) Induced by Rocuronium
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7 After Neuromuscular Block (NMB) Induced by Vecuronium
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8 After Neuromuscular Block (NMB) Induced by Rocuronium
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8 After Neuromuscular Block (NMB) Induced by Vecuronium
NCT00473694 (11) [back to overview]Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.9 After Neuromuscular Block (NMB) Induced by Rocuronium
NCT00491894 (5) [back to overview]Proportion of Responders According to the Modified Teacher's Drooling Scale (mTDS)
NCT00491894 (5) [back to overview]Parent/Caregiver's Global Assessment of Treatment
NCT00491894 (5) [back to overview]Investigator's Global Assessment of Treatment
NCT00491894 (5) [back to overview]Parent/Caregiver's Assessment of the Extent of Drooling Using Visual Analog Scale (VAS)
NCT00491894 (5) [back to overview]Parent/Caregiver's Assessment of the Extent of Drooling Using VAS
NCT00501852 (2) [back to overview]Least Squares Means of FEV1 (L) at Day 1, by Timepoint
NCT00501852 (2) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) Following 7 Days of Treatment
NCT00510510 (2) [back to overview]Safety of Treatment With NVA237 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD)
NCT00510510 (2) [back to overview]Least Squares Means of Trough Forced Expiratory Volume in One Second (FEV1), by Day
NCT00558285 (7) [back to overview]Change From Baseline in QTc (Fridericia's Formula) at Day 7
NCT00558285 (7) [back to overview]Change From Baseline in QTc (Fridericia's Formula) at Day 14
NCT00558285 (7) [back to overview]Change From Baseline in QTc (Fridericia's Formula) at Day 1
NCT00558285 (7) [back to overview]Change From Baseline in Mean 24 Hour Heart Rate at Day 14
NCT00558285 (7) [back to overview]Change From Baseline in Mean 24 Hour Heart Rate at Day 1
NCT00558285 (7) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Day 14
NCT00558285 (7) [back to overview]Trough Forced Vital Capacity (FVC) at Day 1 and Day 14
NCT00570778 (3) [back to overview]Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 7
NCT00570778 (3) [back to overview]Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under Curve (AUC) 5 Minutes-12 Hours at Day 7
NCT00570778 (3) [back to overview]Number of Participants With Adverse Events, Serious Adverse Events and Discontinuations Due to Adverse Events
NCT00856193 (4) [back to overview]Forced Expiratory Volume in One Second (FEV1) Area Under Curve (AUC) 0-24 Hours on Day 14
NCT00856193 (4) [back to overview]Forced Expiratory Volume in One Second (FEV1) AUC 0-12 Hours on Day 14
NCT00856193 (4) [back to overview]Forced Expiratory Volume in One Second (FEV1) AUC 12-24 Hours on Day 14
NCT00856193 (4) [back to overview]Number of Participants Who Experienced Adverse Events (AEs), Serious Adverse Events (SAEs)
NCT00929110 (20) [back to overview]Forced Vital Capacity (FVC) 5, 15, and 30 Minutes; and 1, 2, 3, and 4 Hours Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52
NCT00929110 (20) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1, Week 26, and Week 52
NCT00929110 (20) [back to overview]Trough Forced Vital Capacity (FVC) at Day 1, Week 12, Week 26, and Week 52
NCT00929110 (20) [back to overview]Number of Moderate or Severe Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) Per Year During the Study (Baseline to Week 52)
NCT00929110 (20) [back to overview]"Percentage of Days Able to Perform Usual Daily Activities During the Study (Baseline to Week 52)"
NCT00929110 (20) [back to overview]"Percentage of Days With no Daytime Symptoms During the Study (Baseline to Week 52)"
NCT00929110 (20) [back to overview]"Percentage of Nights With no Nighttime Awakenings During the Study (Baseline to Week 52)"
NCT00929110 (20) [back to overview]Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Taken During the Study (Baseline to Week 52)
NCT00929110 (20) [back to overview]Change From Baseline in the Mean Daily Total Symptom Score During the Study (Baseline to Week 52)
NCT00929110 (20) [back to overview]Health-related Quality of Life (QoL) Assessed With the St. George Respiratory Questionnaire (SGRQ) at Week 52
NCT00929110 (20) [back to overview]Percentage of Patients Who Experienced a Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During the Study (Baseline to Week 52)
NCT00929110 (20) [back to overview]Time to First Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During the Study (Baseline to Week 52)
NCT00929110 (20) [back to overview]Transition Dyspnea Index (TDI) at Week 26
NCT00929110 (20) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) at Week 12
NCT00929110 (20) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) 5, 15, and 30 Minutes; 1, 2, 3, 4, 6, 8, 10, and 12 Hours; 23 Hours 15 Minutes; and 23 Hours 45 Minutes Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52
NCT00929110 (20) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) 5, 15, and 30 Minutes; and 1, 2, 3, and 4 Hours Post Dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52
NCT00929110 (20) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 12 Hours Post-dose at Day 1 and Weeks 12 and 52
NCT00929110 (20) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 23 Hours 45 Minutes and From 12 Hours to 23 Hours 45 Minutes Post-dose at Weeks 12 and 52
NCT00929110 (20) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 4 Hours Post-dose at Day 1 and Weeks 12, 26, and 52
NCT00929110 (20) [back to overview]Forced Vital Capacity (FVC) 5, 15, and 30 Minutes; 1, 2, 3, 4, 6, 8, 10, and 12 Hours; 23 Hours 15 Minutes; and 23 Hours 45 Minutes Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52
NCT01005901 (17) [back to overview]Trough FEV1 and FVC at Day 1 and Week 26
NCT01005901 (17) [back to overview]Percentage of Nights With no Nighttime Awakenings Over the 26 Week Treatment Period
NCT01005901 (17) [back to overview]Percentage of Days With no Daytime Symptoms Over the 26 Week Treatment Period
NCT01005901 (17) [back to overview]Percentage of Days Able to Perform Usual Daily Activities Over the 26 Week Treatment Period
NCT01005901 (17) [back to overview]Change From Baseline in the Mean Number of Puffs Per Day of Rescue Medication Over the Study Duration (Baseline to Week 26)
NCT01005901 (17) [back to overview]Mean Daily Total Symptom Score Over the 26 Week Treatment Period
NCT01005901 (17) [back to overview]Quality of Life Assessment With St. George's Respiratory Questionnaire (SGRQ) Total Score After 26 Weeks of Treatment
NCT01005901 (17) [back to overview]Number of Participants With Adverse Events, Death, and Serious or Clinically Significant Adverse Events or Related Discontinuations
NCT01005901 (17) [back to overview]Forced Vital Capacity (FVC) at Each Time-point on Day 1 and Week 26
NCT01005901 (17) [back to overview]FEV1 at Each Time-point on Day 1 and Week 26
NCT01005901 (17) [back to overview]FEV1 Area Under the Curve (AUC) (5 Min - 12 Hour) at Day 1, Week 12 and Week 26
NCT01005901 (17) [back to overview]FEV1 Area Under Curve (AUC) (5 Min - 23 Hour 45 Min) at Week 12 and Week 26
NCT01005901 (17) [back to overview]Change in 24-hourly Mean Heart Rate at Day 1, Week 12 and Week 26
NCT01005901 (17) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) at 12 Weeks
NCT01005901 (17) [back to overview]Transition Dyspnea Index (TDI) Focal Score After 26 Weeks of Treatment
NCT01005901 (17) [back to overview]Time to First Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During 26 Weeks of Treatment
NCT01005901 (17) [back to overview]Rate of Moderate or Severe COPD Exacerbations Over the 26 Week Treatment Period
NCT01119937 (11) [back to overview]Number of Participants With Adverse Events, Serious Adverse Events or Death
NCT01119937 (11) [back to overview]Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Timepoint Over the Whole Treatment Period
NCT01119937 (11) [back to overview]Change in St. George Respiratory Questionnaire From Baseline
NCT01119937 (11) [back to overview]Change in Pre-dose FVC From Baseline
NCT01119937 (11) [back to overview]Change in Pre-dose FEV1 From Baseline
NCT01119937 (11) [back to overview]Change From Baseline in Mean Daily Number of Puffs of Rescue Medication Over the Whole Treatment Period
NCT01119937 (11) [back to overview]Number of Patients With Notable Change From Baseline in Fridericia's QTc Values at Any Timepoint Over the Whole Treatment Period
NCT01119937 (11) [back to overview]Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
NCT01119937 (11) [back to overview]Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Timepoint Over the Whole Treatment Period
NCT01119937 (11) [back to overview]Number of Patients With Moderate or Severe COPD Exacerbations
NCT01119937 (11) [back to overview]Time From Randomization Until the Start of the First Moderate or Severe COPD Exacerbation
NCT01119950 (33) [back to overview]Trough Forced Vital Capacity on Days 1, 7 and 14
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours at Day 28 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second at 12 Hours at Day 28 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Vital Capacity at Day 28 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Peak Forced Expiratory Volume in One Second at Day 28 of Treatment
NCT01119950 (33) [back to overview]Trough Forced Expiratory Volume in One Second by Treatment at Day 28
NCT01119950 (33) [back to overview]Trough Forced Vital Capacity After 28 Days of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second Area Under the Curve 0-12 Hours at Day 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours on Days 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second Area Under the Curve 0-4 Hours on Days 1, 7 and 14 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second Area Under the Curve at Different Time Points (0-4 Hours, 0-8 Hours, 0-12 Hours, 12-24 Hours)
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second at 12 Hours on Days 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second of Area Under the Curve 0-8 Hours Days 1, 7, and 14
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second of Area Under the Curve 12-24 Hours Over Days 1, and 14 of Treatment
NCT01119950 (33) [back to overview]Mean Daily Use of Rescue Medication by Treatment at Different Time Points
NCT01119950 (33) [back to overview]Peak Forced Expiratory Volume in One Second on Days 1, 7 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Effect of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours on Days 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-12 Hours at Day 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-4 Hours on Days 1, 7 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve at Different Time Points (0-4 Hours, 0-8 Hours, 0-12 Hours, 12-24 Hours) on Day 28
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second at 12 Hours on Days 1 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second of Area Under the Curve 0-8 Hours Days 1, 7, and 14
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second of Area Under the Curve 12-24 Hours Over Days 1, and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Peak Forced Expiratory Volume in One Second on Days 1, 7 and 14 of Treatment
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Trough Forced Expiratory Volume in One Second at Days 1, 7 and 14
NCT01119950 (33) [back to overview]Percentage of the Maximal Response of NVA237 Doses on Trough Forced Vital Capacity on Days 1, 7 and 14
NCT01119950 (33) [back to overview]Trough Forced Expiratory Volume in One Second at Days 1, 7 and 14
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second AUC 0-24 Hours for Once and Twice Daily Regimens of NVA237 for the Same Total Daily Dose of NVA237, After 28 Days of Treatment
NCT01119950 (33) [back to overview]Trough Forced Expiratory Volume in One Second for Once and Twice Daily Regimens of NVA237 for the Same Total Daily Dose of NVA237
NCT01119950 (33) [back to overview]Peak Forced Expiratory Volume in One Second at Day 28 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours at Day 28 of Treatment
NCT01119950 (33) [back to overview]Forced Expiratory Volume in One Second at 12 Hours on Day 28 of Treatment
NCT01119950 (33) [back to overview]Maximal Response of Incremental Once Daily and Twice Daily Doses of NVA237 That Each Dose Achieves in Relation to the Maximal Effect of NVA237 on Trough Forced Expiratory Volume in One Second at Day 28
NCT01120691 (13) [back to overview]Rate of Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in QVA149 and Open-label Tiotropium Treatment Arms During the Treatment Period.
NCT01120691 (13) [back to overview]Number of Days With Moderate or Severe Exacerbation That Required Treatment With Systemic Corticosteroids and Antibiotics
NCT01120691 (13) [back to overview]Cumulative Rates of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations for Multiple COPD Exacerbation at Different Time Points
NCT01120691 (13) [back to overview]Change in Mean Daily Use (Number of Puffs) of Rescue Therapy Between QVA149, NVA237 and Open Label Tiotropium From Baseling Over the 64 Week Treatment Period
NCT01120691 (13) [back to overview]Time to Study Withdrawal or Premature Discontinuation for Any Reason Between QVA149 (110/50 µg q.d.), NVA237 (50 µg q.d.) and Open Label Tiotropium (18 µg q.d.) During the Treatment Period.
NCT01120691 (13) [back to overview]Time to First Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation Between QVA149, NVA237 and Open Label Tiotropium During the Treatment Period
NCT01120691 (13) [back to overview]Rate of Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in QVA149 and NVA237 Treatment Arms During the Treatment Period.
NCT01120691 (13) [back to overview]Rate of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations Requiring the Use of Both Systemic Glucocorticosteroids and Antibiotics
NCT01120691 (13) [back to overview]Percentage of Patients With Study Withdrawal or Premature Discontinuation for Any Reason Between QVA149 (110/50 µg q.d.), NVA237 (50 µg q.d.) and Open Label Tiotropium (18 µg q.d.)During the Treatment Period
NCT01120691 (13) [back to overview]Change From Baseline of Percentage of Days Without Rescue Therapy Use Between QVA149,NVA237 and Open Label Tiotropium Over the 64 Week Treatment Period
NCT01120691 (13) [back to overview]Pre-dose Forced Expiratory Volume in 1 Second (FEV-1) After 4, 12, 26, 38, 52 and 64 Weeks of Treatment Between QVA149, NVA237 and Open Label Tiotropium
NCT01120691 (13) [back to overview]Pre-dose Forced Vital Capacity (FVC)After 4, 12, 26, 38, 52 and 64 Weeks of Treatment Between QVA149, NVA237 and Open Label Tiotropium
NCT01120691 (13) [back to overview]St. George's Respiratory Questionnaire (SGRQ) Scores Between QVA149, NVA237 and Open Label Tiotropium Over 12, 26, 38, 52 and 64 Weeks of Treatment
NCT01154127 (9) [back to overview]Exercise Endurance Time During a Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks (Day 21) of Treatment
NCT01154127 (9) [back to overview]Specific Airways Conductance (SGaw)
NCT01154127 (9) [back to overview]Slow Vital Capacity (SVC) and Total Lung Capacity (TLC)
NCT01154127 (9) [back to overview]Peak and Trough (24 h Post Dose) Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC)
NCT01154127 (9) [back to overview]Inspiratory Capacity (IC) at Rest (1 Hour Post Dose) and at Peak (End of Exercise) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks of Treatment
NCT01154127 (9) [back to overview]Leg Discomfort (Borg CR10 Scale) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks Treatment
NCT01154127 (9) [back to overview]Exertional Dyspnea (Borg CR10 Scale) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks Treatment
NCT01154127 (9) [back to overview]Exercise Endurance Time During a Sub-maximal Constant-load Cycle Ergometry Test (SMETT) on Treatment Day 1
NCT01154127 (9) [back to overview]Isotime Inspiratory Capacity (IC) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks of Treatment
NCT01191398 (2) [back to overview]Monitoring of Adverse Events During Study Administration
NCT01191398 (2) [back to overview]Difference in Salivary Flow Rate (ml/Min) Between Study Groups
NCT01199237 (5) [back to overview]Time From Potent Inhaled Anesthetic Discontinuation to First Response to Command (T1)
NCT01199237 (5) [back to overview]Recovery of Ability to Swallow After Neostigmine/Glycopyrrolate Antagonism of Rocuronium Paralysis.
NCT01199237 (5) [back to overview]Time From Anesthetic Discontinuation to First Ability to Swallow
NCT01199237 (5) [back to overview]Nausea and Vomiting
NCT01199237 (5) [back to overview]Nausea and Vomiting
NCT01202188 (23) [back to overview]Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 4 Hours at Day 1 and Week 26
NCT01202188 (23) [back to overview]"Percentage of Days Able to Perform Usual Daily Activities Over 26 Weeks"
NCT01202188 (23) [back to overview]Transitional Dyspnea Index (TDI) Focal Score at Week 26
NCT01202188 (23) [back to overview]Percentage of Patients With at Least One Moderate or Severe COPD Exacerbation Over the 26 Week Treatment Period
NCT01202188 (23) [back to overview]Baseline Transitional Dyspnea Index (BDI/TDI) Focal Score at Week 12 and Week 26
NCT01202188 (23) [back to overview]Change From Baseline (BL) in the Daytime and Night Time Rescue Medication Use (Number of Puffs) Over 26 Weeks
NCT01202188 (23) [back to overview]Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication at Week 12 and Week 26
NCT01202188 (23) [back to overview]Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment
NCT01202188 (23) [back to overview]Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment With QVA149 Compared to Tiotropium
NCT01202188 (23) [back to overview]Percentage of Participants With COPD Exacerbations Requiring Hospitalization or Treatment With Systemic Corticosteroids and/or Antibiotics But no Hospitalization
NCT01202188 (23) [back to overview]Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 23 Hours 45 Minutes at Week 26
NCT01202188 (23) [back to overview]St. George's Respiratory Questionnaire (SGRQ) Total Score at Week 26
NCT01202188 (23) [back to overview]Rate of Moderate or Severe COPD Exacerbation
NCT01202188 (23) [back to overview]Percentage of Patients With a Clinically Important Improvement of at Least 1 Point in TDI Focal Score After 26 Weeks of Treatment
NCT01202188 (23) [back to overview]Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment With QVA149, QAB149 and NVA237 Compared to Placebo
NCT01202188 (23) [back to overview]Percentage of Patients With a Clinically Important Improvement From Baseline of at Least 4 Units in the SGRQ Total Score After 26 Weeks of Treatment
NCT01202188 (23) [back to overview]24 Hour Holter Monitoring in a Subset of Patients
NCT01202188 (23) [back to overview]Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Over 26 Weeks
NCT01202188 (23) [back to overview]"Percentage of Nights With No Night Time Awakenings Over 26 Weeks"
NCT01202188 (23) [back to overview]"Percentage of Days With no Rescue Medication Use Over 26 Weeks"
NCT01202188 (23) [back to overview]"Percentage of Days With No Daytime Symptoms Over 26 Weeks"
NCT01202188 (23) [back to overview]Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 12 Hours at Day 1 and Week 26
NCT01202188 (23) [back to overview]St. George's Respiratory Questionnaire (SGRQ) Total Score After 12 and 26 Weeks of Treatment
NCT01294787 (13) [back to overview]Pulmonary Function Test (RV) Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Pulmonary Function Test (SGaw) Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Pulmonary Function Test Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Dynamic Inspiratory Capacity Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Exercise Endurance Comparison Between QVA149 and Tiotropium Groups
NCT01294787 (13) [back to overview]Exercise Endurance Time Comparison After a Single Dose of QVA149 Versus Placebo
NCT01294787 (13) [back to overview]Exercise Tolerance Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Exertional Dyspnea Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Leg Discomfort During Exercise Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Spirometry After Three Weeks of Treatment on Patients Not Exercising
NCT01294787 (13) [back to overview]Trough 24 Hour Post Dose Forced Expiratory Volume in One Second Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Trough 24 Hour Post Dose Inspiratory Capacity Comparison Between QVA149 and Placebo Groups
NCT01294787 (13) [back to overview]Pulmonary Function Test (FRC) Comparison Between QVA149 and Placebo Groups
NCT01315249 (11) [back to overview]Number of Participants With Adverse Events
NCT01315249 (11) [back to overview]Mean Change From Baseline in Daily Number of Puffs of Rescue Medication
NCT01315249 (11) [back to overview]Inspiratory Capacity (IC) at All-time Points (26 Weeks)
NCT01315249 (11) [back to overview]Inspiratory Capacity (IC) at All-time Points (12 Weeks)
NCT01315249 (11) [back to overview]Forced Vital Capacity at All-time Points (Week 26)
NCT01315249 (11) [back to overview]Forced Vital Capacity at All-time Points (Week 12)
NCT01315249 (11) [back to overview]Change From Baseline in Symptom Scores Reported Using the Ediary
NCT01315249 (11) [back to overview]Standardized Forced Expiratory Volume in 1 Second Area Under the Curve (FEV1 AUC) 0-12 Hours
NCT01315249 (11) [back to overview]Forced Expiratory Volume in 1 Second Area Under the Curve (FEV1 AUC) 0-12
NCT01315249 (11) [back to overview]Focal Score of the Transitional Dyspnea Index (TDI)
NCT01315249 (11) [back to overview]Total Score of the St. George's Respiratory Questionnaire (SGRQ-C)
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Events of Bleeding (Major or Non-major) With Onset Within 24 Hours After Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Events of Bleeding (Major or Non-major) With Onset Within 14 Days After Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants With One or More Postoperative Anemia Adverse Events With Onset Within 72 Hours After Study Drug Administration
NCT01422304 (13) [back to overview]Percent Change From Baseline in Prothrombin Time (International Normalized Ratio) (PT[INR]) at 10 and 60 Minutes Post Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Major Events of Bleeding With Onset Within 14 Days After Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Venous Thromboembolic (VTE) Events With Onset Within 14 Days After Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Events of Anaphylaxis With Onset Within 14 Days After Study Drug Administration
NCT01422304 (13) [back to overview]Number of Participants Requiring Any Postoperative Transfusion
NCT01422304 (13) [back to overview]Number of Participants With One or More Adjudicated Major Events of Bleeding With Onset Within 24 Hours After Study Drug Administration
NCT01422304 (13) [back to overview]Percent Change From Baseline in Activated Partial Thromboplastin Time (aPTT) at 10 and 60 Minutes Post Study Drug Administration
NCT01422304 (13) [back to overview]Total Transfusion Volume in Participants Who Required Postoperative Transfusion
NCT01422304 (13) [back to overview]Postoperative Drainage Volume Within 24 Hours After Study Drug Administration
NCT01422304 (13) [back to overview]Postoperative Changes in Hgb Concentrations Using the Bleeding Index
NCT01479764 (2) [back to overview]Incidence of Residual Neuromuscular Blockade (NMB) as Defined by a Train-of-Four (TOF) Ratio <0.9 at Post Anesthesia Care Unit (PACU) Entry
NCT01479764 (2) [back to overview]Time From Start of Study Drug Administration to Operating Room Discharge-ready
NCT01490125 (6) [back to overview]Total Total Transient Dyspnea Index (TDI) Score After 6 Weeks of Treatment QVA149 Compared to Tiotropium
NCT01490125 (6) [back to overview]Total Total Transient Dyspnea Index (TDI) Score After 6 Weeks of Treatment QVA149 Compared to Placebo
NCT01490125 (6) [back to overview]Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Used Over the 6 Weeks of Treatment
NCT01490125 (6) [back to overview]Standardized Forced Vital Capacity (FVC) Area Under the Curve (AUC) 5min-4 Hrs After First Dose and 6 Weeks of Treatment With QVA149 Compared to Placebo and Tiotropium
NCT01490125 (6) [back to overview]Change From Baseline in The Capacity of Daily Living During the Morning (CDLM) Score Averaged Over 6 Weeks of Treatment
NCT01490125 (6) [back to overview]Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 5min-4h After First Dose and 6 Weeks of Treatment With QVA149 Compared to Placebo and Tiotropium
NCT01513460 (7) [back to overview]Mean Percentage of Nights With 'no Nighttime Awakenings'
NCT01513460 (7) [back to overview]Mean Percentage of Days With Performance of Usual Activities
NCT01513460 (7) [back to overview]Change From Baseline in Total Score of the St George's Respiratory Questionnaire for COPD Patients (SGRQ-C) After 12 Weeks of Treatment
NCT01513460 (7) [back to overview]Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Use
NCT01513460 (7) [back to overview]Change From Baseline in Mean Trough Forced Expiratory Volume in 1 Second (FEV1) (NVA237 Versus Tiotropium)
NCT01513460 (7) [back to overview]Change From Baseline in Mean Trough FEV1
NCT01513460 (7) [back to overview]Change From Baseline in Mean Trough FEV1 (Flu/Sal Versus NVA237/Tiotropium+Flu/Sal)
NCT01529632 (7) [back to overview]Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28
NCT01529632 (7) [back to overview]Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-dose
NCT01529632 (7) [back to overview]Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of Treatment
NCT01529632 (7) [back to overview]Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of Treatment
NCT01529632 (7) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 28
NCT01529632 (7) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 1
NCT01529632 (7) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded Treatment
NCT01566604 (11) [back to overview]Change From Baseline in Daily Rescue Medication Use (Number of Puffs)
NCT01566604 (11) [back to overview]Number of Moderate and Severe COPD Exacerbations
NCT01566604 (11) [back to overview]Time to First Moderate or Severe COPD Exacerbation
NCT01566604 (11) [back to overview]Trough Forced Expiratory Volume in One Second (FEV1)
NCT01566604 (11) [back to overview]24h Trough FEV1
NCT01566604 (11) [back to overview]Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Symptoms (Cough, Wheezing, Shortness of Breath, Sputum Volume, Sputum Color and Night Time Awakenings)
NCT01566604 (11) [back to overview]FEV1 and Forced Vital Capacity (FVC)
NCT01566604 (11) [back to overview]Peak FEV1
NCT01566604 (11) [back to overview]Standardized FEV1 Area Under the Curve (AUC(5 Min-4 h)) Post-dose
NCT01566604 (11) [back to overview]The Total Score of the St George's Respiratory Questionnaire (SGRQ)
NCT01566604 (11) [back to overview]Transition Dyspnea Index (TDI) Score
NCT01574651 (9) [back to overview]Trough FEV1 at Baseline and Week 26
NCT01574651 (9) [back to overview]Percent of Participants With at Least One Exacerbation Requiring Hospitalization
NCT01574651 (9) [back to overview]Percent of Participants With at Least One Exacerbation Requiring Systemic Corticosteroids and/or Antibiotics Over 26 Weeks
NCT01574651 (9) [back to overview]Time- Event Analysis, Number of Participants With at Least One COPD Exacerbation (Moderate or Severe) During the Treatment Period
NCT01574651 (9) [back to overview]"Symptoms Score Reported by the Patients Using Part I Symptoms of SGRO-C"
NCT01574651 (9) [back to overview]FEV1 30 Min After the Morning Dose at Baseline and Week 26
NCT01574651 (9) [back to overview]St. George's Respiratory Questionnaire (SGRQ-C) Total Score After 26 Weeks of Treatment (Non-inferiority Analysis).
NCT01574651 (9) [back to overview]Transition Dyspnea Index (TDI) Focal Score After 26 Weeks of Treatment.
NCT01574651 (9) [back to overview]St. George's Respiratory Questionnaire (SGRQ-C) Total Score After 26 Weeks of Treatment (Superiority Analysis).
NCT01604278 (10) [back to overview]Change From Baseline in Mean Daily Total and Individual Symptom Scores
NCT01604278 (10) [back to overview]Change From Baseline in Mean Daily Number of Puffs of Rescue Medication
NCT01604278 (10) [back to overview]FEV(1) Area Under the Curve (AUC) During 30 Minutes to 4 Hours Post Dose
NCT01604278 (10) [back to overview]Peak FEV1 During 30 Minutes to 4 Hours Post-dose at 12 Weeks
NCT01604278 (10) [back to overview]Transitional Dyspnea Index (TDI) Focal Score
NCT01604278 (10) [back to overview]Trough Forced Expiratory Volume at 1 Second (FEV1)
NCT01604278 (10) [back to overview]Number of Participants With Adverse Events and Serious Adverse Events
NCT01604278 (10) [back to overview]Inspiratory Capacity (IC) at Individual Time-points
NCT01604278 (10) [back to overview]Forced Vital Capacity (FVC) at Individual Time-points
NCT01604278 (10) [back to overview]FEV1 at Individual Time-points
NCT01613326 (13) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) After 12 Weeks of Treatment (Analysis of Superiority)
NCT01613326 (13) [back to overview]Transition Dyspnea Index (TDI) Focal Score After 4 Weeks and 12 Weeks of Treatment
NCT01613326 (13) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Week 4
NCT01613326 (13) [back to overview]Peak Forced Expiratory Volume in 1 Second (FEV1) During 5 Min to 4 Hours Post-dose, at Day 1 and Week 12
NCT01613326 (13) [back to overview]St. George's Respiratory Questionnaire Total Score After 12 Weeks of Treatment
NCT01613326 (13) [back to overview]Trough Forced Expiratory Volume in 1 Second (FEV1) After 12 Weeks of Treatment (Non-inferiority Analysis)
NCT01613326 (13) [back to overview]Change From Baseline in Mean Daily Number of Puffs of Rescue Medication Used Over the 12 Week Treatment
NCT01613326 (13) [back to overview]Event Free Rate at Weeks 4, 8 and 12 After Treatment
NCT01613326 (13) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) at Each Time-point by Visit
NCT01613326 (13) [back to overview]Forced Vital Capacity (FVC) at Each Time-point by Visit
NCT01613326 (13) [back to overview]Inspiratory Capacity (IC) at Each Time-point, by Visit
NCT01613326 (13) [back to overview]Mean Daily, Daytime and Nighttime (Combined) Symptom Scores Over the 12 Week Treatment Period
NCT01613326 (13) [back to overview]Standardized Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC) (5 Min-4 h) Post-dose
NCT01682863 (8) [back to overview]Time to Premature Discontinuation of Treatment
NCT01682863 (8) [back to overview]Change From Baseline in 1 Hour Post-dose FEV1 Measurements
NCT01682863 (8) [back to overview]Change From Baseline in FVC Measurement at All Post-baseline Time Points
NCT01682863 (8) [back to overview]Change From Baseline in Pre-dose Trough FEV1
NCT01682863 (8) [back to overview]Number of Patients With Adverse Events, Serious Adverse Events, and Death
NCT01682863 (8) [back to overview]Change From Baseline in Mean Total Daily Symptom Scores
NCT01682863 (8) [back to overview]Change From Baseline in the Daily Number of Puffs of Rescue Medication Over the 52 Week Period
NCT01682863 (8) [back to overview]Percentage of Participants Experiencing Moderate or Severe COPD Exacerbation
NCT01697696 (9) [back to overview]Change From Baseline in Pre-dose Forced Vital Capacity (FVC) at All Post-baseline Timepoints
NCT01697696 (9) [back to overview]Change From Baseline in Pre-dose Forced Expiratory Volume (FEV1) in One Second at All Post Baseline Timepoints
NCT01697696 (9) [back to overview]Change From Baseline in Mean Forced Expiratory Volume (Average of the Two FEV1 Measurements 45 and 15 Minutes Pre-dose) in One Second at Week 52
NCT01697696 (9) [back to overview]Percentage of Participants Reporting Safety and Tolerability in Terms of Adverse Event (AE) Reporting Rate
NCT01697696 (9) [back to overview]Time to First COPD Exacerbation (Moderate or Severe).
NCT01697696 (9) [back to overview]Time to Treatment Discontinuation
NCT01697696 (9) [back to overview]Change From Baseline in Mean Daily Number of Puffs of Rescue Medication
NCT01697696 (9) [back to overview]Change From Baseline in COPD Symptoms
NCT01697696 (9) [back to overview]Change From Baseline in COPD Symptoms
NCT01699685 (6) [back to overview]Inspiratory Capacity (IC)
NCT01699685 (6) [back to overview]Inspiratory Capacity (IC) Peak Value
NCT01699685 (6) [back to overview]Total Lung Capacity (TLC)
NCT01699685 (6) [back to overview]Airway Resistance (Raw)
NCT01699685 (6) [back to overview]Forced Expiratory Volume in One Second (FEV1)
NCT01699685 (6) [back to overview]Forced Volume Capacity (FVC)
NCT01709864 (15) [back to overview]Change From Baseline of Morning and Nighttime Symptom Scores at Week 12
NCT01709864 (15) [back to overview]"Percentage of Days Able to Perform Usual Daily Activities"
NCT01709864 (15) [back to overview]Change From Baseline of Daily Symptom Scores
NCT01709864 (15) [back to overview]"Percentage of Nights With no Nighttime Awakenings"
NCT01709864 (15) [back to overview]"Percentage of Days With no Daytime Symptoms"
NCT01709864 (15) [back to overview]Breathlessness Assessed by Transition Dyspnea Index (TDI) Focal Score at Week 12
NCT01709864 (15) [back to overview]Change From Baseline in the Health Status Assessed by St. George's Respiratory Questionnaire
NCT01709864 (15) [back to overview]Change From Baseline of Forced Vital Capacity (FVC) at All Individual Timepoints at Day 1 and at Week 12 (Day 85)
NCT01709864 (15) [back to overview]Change From Baseline of Forced Expiratory Volume in One Second (FEV1) at All Individual Timepoints at Day 1 and at Week 12 (Day 85)
NCT01709864 (15) [back to overview]Change From Baseline in Trough FEV1 and Pre-dose Trough FEV1 by Visit
NCT01709864 (15) [back to overview]Change From Baseline in FEV1 AUC (0-12H) at Day 1 and FEV1 AUC (0-4h), AUC (4-8h), AUC (8-12h) at Day 1 and Week 12 (Day 85)
NCT01709864 (15) [back to overview]The Average Number of Puffs of Rescue Medication Per Day
NCT01709864 (15) [back to overview]Percentage of Participants With a Clinically Important Improvement of >=4units in the SGRQ Total Score at Week 12
NCT01709864 (15) [back to overview]Percentage of Days Without Rescue Medication Use
NCT01709864 (15) [back to overview]Change From Baseline of Standardized Area Under the Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) Post Dosing
NCT01709903 (9) [back to overview]Analysis of FEV1 (L) Trough Response (Pre-dose) Over the Whole Treatment Period
NCT01709903 (9) [back to overview]Trough Forced Expiratory Volume in One Second (FEV1) Following 26 Weeks of Treatment to Demonstrate the Superiority of QVA 110/50μg o.d. to Fluticasone/Salmeterol 500/50 μg b.i.d
NCT01709903 (9) [back to overview]Trough Forced Expiratory Volume in One Second (FEV1) Following 26 Weeks of Treatment to Demonstrate the Non-inferiority of QVA149 110/50 μg o.d. to Fluticasone/Salmeterol 500/50 μg b.i.d
NCT01709903 (9) [back to overview]Analysis of the TDI Focal Score Over the Whole Treatment Period
NCT01709903 (9) [back to overview]Symptoms Reported Using E-diary Over 12 and 26 Weeks of Treatment
NCT01709903 (9) [back to overview]Rescue Medication Use: Summary of the Mean Daily, Daytime and Nighttime Number of Puffs of Rescue Medication, by 4 Weekly Intervals
NCT01709903 (9) [back to overview]Health Related Quality of Life Analysis of SGRQ Total Score After 26 Weeks of Treatment
NCT01709903 (9) [back to overview]Analysis of Trough FVC (L) Over the Whole Treatment Period
NCT01709903 (9) [back to overview]Standardized Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC) 0-4 Hours
NCT01712516 (11) [back to overview]Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score
NCT01712516 (11) [back to overview]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)
NCT01712516 (11) [back to overview]Secondary: Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom Score
NCT01712516 (11) [back to overview]Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
NCT01712516 (11) [back to overview]Change From Baseline in Pre-dose Trough FEV1
NCT01712516 (11) [back to overview]Secondary: Change From Baseline in Mean Daily Number of Puffs of Rescue Medication
NCT01712516 (11) [back to overview]Change From Baseline in FEV1
NCT01712516 (11) [back to overview]Change From Baseline in FVC
NCT01712516 (11) [back to overview]Transitional Dyspnea Index (TDI) Focal Score
NCT01712516 (11) [back to overview]Change From Baseline in Trough FEV1
NCT01712516 (11) [back to overview]Primary: Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))
NCT01715298 (16) [back to overview]Change From Baseline in Standardized Area Under The Curve for Forced Expiratory Volume in One Second for Different Time Spans Post Dosing
NCT01715298 (16) [back to overview]Change From Baseline in Morning and Nighttime Symptom Scores
NCT01715298 (16) [back to overview]Change From Baseline in Mean Trough Forced Vital Capacity
NCT01715298 (16) [back to overview]Change From Baseline in Forced Vital Capacity at All Individual Timepoints
NCT01715298 (16) [back to overview]Change From Baseline in Forced Expiratory Volume in One Second at All Individual Timepoints
NCT01715298 (16) [back to overview]Change From Baseline in the Percentage of Days Without Rescue Medication Use
NCT01715298 (16) [back to overview]Change From Baseline in the Health Status Assessed by St. George's Respiratory Questionnaire
NCT01715298 (16) [back to overview]Change From Baseline in Standardized Area Under the Curve for Forced Expiratory Volume in One Second Post Dosing
NCT01715298 (16) [back to overview]Change From Baseline in Standardized Area Under the Curve (AUC(0-12h)) for Forced Expiratory Volume in One Second Post Dosing
NCT01715298 (16) [back to overview]Change From Baseline in Mean Number of Puffs of Rescue Medication Per Day
NCT01715298 (16) [back to overview]Change From Baseline in Daily Symptom Scores
NCT01715298 (16) [back to overview]Breathlessness Assessed by Transition Dyspnea Index
NCT01715298 (16) [back to overview]"Change From Baseline in the Percentage of Nights With no Nighttime Awakenings"
NCT01715298 (16) [back to overview]"Change From Baseline in the Percentage of Days With no Daytime Symptoms"
NCT01715298 (16) [back to overview]"Change From Baseline in Percentage of Days Able to Perform Usual Daily Activities"
NCT01715298 (16) [back to overview]Mean Trough Forced Expiratory Volume in One Second
NCT01727141 (11) [back to overview]Change From Baseline in Pre-dose Trough FEV1
NCT01727141 (11) [back to overview]Change From Baseline in Mean Daily Number of Puffs of Rescue Medication
NCT01727141 (11) [back to overview]Change From Baseline in Trough FEV1
NCT01727141 (11) [back to overview]Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)
NCT01727141 (11) [back to overview]Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom Score
NCT01727141 (11) [back to overview]Change From Baseline in FVC
NCT01727141 (11) [back to overview]Change From Baseline in FEV1
NCT01727141 (11) [back to overview]Transitional Dyspnea Index (TDI) Focal Score
NCT01727141 (11) [back to overview]Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score
NCT01727141 (11) [back to overview]Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))
NCT01727141 (11) [back to overview]Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
NCT01748643 (6) [back to overview]Subjective Evaluation of the View on the Operating Field by the Surgeon
NCT01748643 (6) [back to overview]Peak Expiratory Flow
NCT01748643 (6) [back to overview]Forced Vital Capacity
NCT01748643 (6) [back to overview]Number of Intra-abdominal Pressure Rises > 18cmH2O
NCT01748643 (6) [back to overview]Forced Expiratory Volume in 1 Second
NCT01748643 (6) [back to overview]Duration of Surgery
NCT01854658 (6) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1
NCT01854658 (6) [back to overview]Rescue Ventolin HFA Use
NCT01854658 (6) [back to overview]Peak FEV1
NCT01854658 (6) [back to overview]Onset of Action as Assessed by FEV1
NCT01854658 (6) [back to overview]St. George Respiratory Questionnaire (SGRQ) Score
NCT01854658 (6) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1 Over 24 Weeks
NCT01922271 (7) [back to overview]Residual Volume (RV)
NCT01922271 (7) [back to overview]Inspiratory Capacity (IC)
NCT01922271 (7) [back to overview]Functional Resistance Capacity (FRCpleth)
NCT01922271 (7) [back to overview]Forced Expiratory Volume in One Second (FEV1) Area Under Curve (AUC) 0-2
NCT01922271 (7) [back to overview]Forced Expiratory Volume in One Second (FEV1) 15 Min Post Dose
NCT01922271 (7) [back to overview]Specific Airway Resistance (sRAW)
NCT01922271 (7) [back to overview]Total Lung Capacity (TLC)
NCT01959516 (2) [back to overview]Comparison of Glycopyrronium QD Versus Tiotropium QD on Symptoms Outcome
NCT01959516 (2) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) AUC0-4h After First Dose of Treatment.
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA or LAMA Monotherapy or LABA and ICS in Free or FDC on Trough FEV1 at Week 12.
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA and ICS in Free or FDC
NCT01985334 (16) [back to overview]Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA or LAMA Monotherapy or LABA and ICS in Free or FDC
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC) or vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Mean Change From Baseline Reported Symptoms of COPD for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC
NCT01985334 (16) [back to overview]Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA and ICS in Free or FDC
NCT01985334 (16) [back to overview]Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC)
NCT01985334 (16) [back to overview]Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Change From Baseline on Total Score of COPD Assessment Test (CAT) for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC
NCT01985334 (16) [back to overview]Change From Baseline on Total Score of Clinical COPD Questionnaire (CCQ) for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC
NCT01985334 (16) [back to overview]Change From Baseline on on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC) or Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Mean Number of Puffs of Rescue Medication Use for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)
NCT01985334 (16) [back to overview]Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC)
NCT02016885 (6) [back to overview]Percentage of Subjects Who Have a Minimum 2-grade Improvement in HDSS From Baseline at Week 4
NCT02016885 (6) [back to overview]Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 6
NCT02016885 (6) [back to overview]Change in Dermatology Life Quality Index (DLQI) From Baseline at Week 4
NCT02016885 (6) [back to overview]Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 6
NCT02016885 (6) [back to overview]Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 4
NCT02016885 (6) [back to overview]Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 4
NCT02129660 (7) [back to overview]Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 4
NCT02129660 (7) [back to overview]Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 6
NCT02129660 (7) [back to overview]Percentage of Subjects Who Have a Minimum 2-grade Improvement in HDSS From Baseline at Week 4
NCT02129660 (7) [back to overview]Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 4
NCT02129660 (7) [back to overview]Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 6
NCT02129660 (7) [back to overview]Percentage of Subjects Who Had at Least 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4
NCT02129660 (7) [back to overview]Percentage of Subjects Who Had at Least 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 6
NCT02196714 (38) [back to overview]T 1/2
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Vd/F
NCT02196714 (38) [back to overview]Vd/F
NCT02196714 (38) [back to overview]Tmax
NCT02196714 (38) [back to overview]Tmax
NCT02196714 (38) [back to overview]T 1/2
NCT02196714 (38) [back to overview]Lambda z
NCT02196714 (38) [back to overview]Lambda z
NCT02196714 (38) [back to overview]Cmax
NCT02196714 (38) [back to overview]Cmax
NCT02196714 (38) [back to overview]CL/F
NCT02196714 (38) [back to overview]CL/F
NCT02196714 (38) [back to overview]Change in QTc Fridericia's Interval From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]Change in QTc Bazett Interval From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]AUC 0-∞
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Glucose and Potassium Results (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in QT Interval From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]AUC 0-∞
NCT02196714 (38) [back to overview]AUC 0-12
NCT02196714 (38) [back to overview]AUC 0-12
NCT02196714 (38) [back to overview]AUC 0-t
NCT02196714 (38) [back to overview]Change in QRS Duration From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]AUC 0-t
NCT02196714 (38) [back to overview]Change in Heart Rate From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02196714 (38) [back to overview]Change in PR Interval From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]Change in QRS Axis From Pre-dose to 12 Hours Post Dose
NCT02196714 (38) [back to overview]Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose
NCT02202616 (4) [back to overview]Change From Baseline in Trough FEV1 (Forced Expiratory Volume) to Week 4
NCT02202616 (4) [back to overview]Single Point and Change in Baseline Dyspnea Index and Transitional Dyspnea Index (BDI/TDI)
NCT02202616 (4) [back to overview]Change From Baseline in Trough (Forced Expiratory Volume (FEV1) (Pre-dose FEV1)
NCT02202616 (4) [back to overview]Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Assessment Questionnaire (CAT)
NCT02233543 (2) [back to overview]Percent of Time Spent During the Night Below 90 % in Blood Oxygen Saturation
NCT02233543 (2) [back to overview]Mean Night-time Blood Oxygenation
NCT02236611 (1) [back to overview]Change From Baseline in Trough FEV1 on Day 85
NCT02268396 (6) [back to overview]Percentage of Devices in Agreement Between Laboratory-advanced Does Indicator Actuation and Weight-based Actuation Count at Last Available Visit.
NCT02268396 (6) [back to overview]Percentage of Devices in Agreement Between Laboratory-Advanced Dose Indicator Actuation Count and Subject-Reported Actuation Count at the Last Available Visit
NCT02268396 (6) [back to overview]Percentage of Devices Where the Dose Indicator Actuation Count is >20 Less Than the Subject-reported Actuation Count (Undercount)
NCT02268396 (6) [back to overview]Percentage of Correct Advances (±2 or ±4 Actuations) of the Dose Indicator Based on Subject-reported Actuation Count
NCT02268396 (6) [back to overview]Percentage of Devices in Agreement Between eCRF-Based Dose Indicator Actuation Count and Weight-Based Actuation Count at the Last Available Visit
NCT02268396 (6) [back to overview]Dose Indicator Actuation Consistency: Percentage of Devices in Agreement Between CRF-Based Dose Indicator Actuation Count
NCT02276222 (10) [back to overview]Percentage of Subjects With Treatment-emergent Serious Adverse
NCT02276222 (10) [back to overview]Percentage of Subjects Who Discontinue the Study Due to TEAE
NCT02276222 (10) [back to overview]Number of Subjects With Treatment-emergent Serious Adverse Events (SAE)
NCT02276222 (10) [back to overview]Number of Subjects With Treatment-emergent Adverse Events (TEAE)
NCT02276222 (10) [back to overview]Percentage of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke
NCT02276222 (10) [back to overview]Number of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke
NCT02276222 (10) [back to overview]Incidence Rate Per 1000 Person Years of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke
NCT02276222 (10) [back to overview]Number of Subjects Who Discontinue the Study Due to TEAE
NCT02276222 (10) [back to overview]Mean Change From Baseline Over 48 Weeks in Trough FEV1 for All Subjects
NCT02276222 (10) [back to overview]Percentage of Subjects With Treatment-emergent Adverse Events
NCT02343458 (17) [back to overview]Change From Baseline in SGRQ Total Score Over Weeks 12-24 , Japan & EU/SK/TW Approach
NCT02343458 (17) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1 Over Weeks 12-24, Japan Approach
NCT02343458 (17) [back to overview]Change From Baseline in SGRQ Total Score at Week 24, US/China Approach
NCT02343458 (17) [back to overview]Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks EU/SK/TW Approach
NCT02343458 (17) [back to overview]Change From Baseline in SGRQ Total Score at Week 24 in Symptomatic Population, US/China Approach
NCT02343458 (17) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1 Over 24 Weeks. Primary Endpoint, EU/SK/TW Approach, Secondary Endpoint US/China Approach.
NCT02343458 (17) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1 at Week 24 of Treatment (US/China Approach)
NCT02343458 (17) [back to overview]TDI Focal Score Over 24 Weeks - US/China and EU/SK/TW Approaches -Symptomatic Population
NCT02343458 (17) [back to overview]TDI Focal Score Over 24 Weeks, US/China and EU/SK/TW Approach
NCT02343458 (17) [back to overview]TDI Focal Score Over Weeks 12-24 - Japan Approach - Symptomatic Population
NCT02343458 (17) [back to overview]TDI Focal Score Over Weeks 12-24 Japan Approach
NCT02343458 (17) [back to overview]FEV1 Measured at 5 Minutes Post-dose on Day 1
NCT02343458 (17) [back to overview]Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing at Week 24 US/China Approach
NCT02343458 (17) [back to overview]Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over Weeks 12-24 Japan Approach
NCT02343458 (17) [back to overview]FEV1 Measured at 15 Minutes Post-dose on Day 1
NCT02343458 (17) [back to overview]Change From Baseline in SGRQ Total Score Over Weeks 12-24, in Symptomatic Population, Japan & EU/SK/TW Approach
NCT02343458 (17) [back to overview]Change From Baseline in Average Daily Rescue Ventolin Use Over 24 Weeks in RVU Population, All Approaches
NCT02347072 (9) [back to overview]Morning Pre-Dose Trough FEV1 on Day 30
NCT02347072 (9) [back to overview]Morning Pre-Dose Trough FEV1 on Day 29
NCT02347072 (9) [back to overview]Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-24
NCT02347072 (9) [back to overview]FEV1 AUC0-12
NCT02347072 (9) [back to overview]Peak Change From Baseline in FEV1 Morning
NCT02347072 (9) [back to overview]Peak Change From Baseline in IC (Inspiratory Capacity) Evening
NCT02347072 (9) [back to overview]Peak Change From Baseline in IC Morning
NCT02347072 (9) [back to overview]FEV1 AUC12-24
NCT02347072 (9) [back to overview]Peak Change From Baseline in FEV1 Evening
NCT02347085 (9) [back to overview]Morning Pre-Dose Trough FEV1 on Day 29
NCT02347085 (9) [back to overview]FEV1 AUC12-24 on Day 29
NCT02347085 (9) [back to overview]FEV1 AUC0-24 on Day 29
NCT02347085 (9) [back to overview]Peak Change From Baseline in Inspiratory Capacity (IC) Following the Evening Dose on Day 29
NCT02347085 (9) [back to overview]Peak Change From Baseline in IC Following the Morning Dose on Day 29
NCT02347085 (9) [back to overview]Peak Change From Baseline in FEV1 on Day 29
NCT02347085 (9) [back to overview]Peak Change From Baseline in FEV1 on Day 29
NCT02347085 (9) [back to overview]Morning Pre-Dose Trough FEV1 on Day 30
NCT02347085 (9) [back to overview]FEV1 AUC0-12 on Day 29
NCT02371629 (15) [back to overview]Change From Baseline in Area Under The Curve (AUC 0-12 Hour) for Forced Expiratory Volume in One Second (FEV1) Post Dosing at Day 1
NCT02371629 (15) [back to overview]Change From Baseline in the Percentage of Days With no Rescue Medication Use Over the 26 Weeks
NCT02371629 (15) [back to overview]Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Week 12
NCT02371629 (15) [back to overview]Change From Baseline in Area Under The Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) for Different Time Spans Post Dosing at Week 12
NCT02371629 (15) [back to overview]Change From Baseline in Area Under The Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) for Different Time Spans Post Dosing at Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Forced Vital Capacity (FVC) at Individual Timepoints at Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Inspiratory Capacity (IC) at Individual Timepoints at Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Mean Daily COPD Symptom Score at Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Total St. George's Respiratory Questionnaire (SGRQ) Score at Week 12 and Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Transitional Dyspnea Index (TDI) Focal Score at Week 12 and Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Week 26
NCT02371629 (15) [back to overview]Number of Patients With Adverse Events, Serious Adverse Events and Death
NCT02371629 (15) [back to overview]Percentage of Patients With a Clinically Important Improvement on Transitional Dyspnea Index (TDI) Focal Score at Week 12 and Week 26
NCT02371629 (15) [back to overview]Percentage of Patients With a Clinically Significant Improvement in St George Respiratory Questionnaire at Week 12 and Week 26
NCT02371629 (15) [back to overview]Change From Baseline in Forced Expiratory Volume in One Second (FEV1) at Individual Timepoints at Week 26
NCT02433834 (7) [back to overview]Peak Change From Baseline in FEV1 Within 3 Hours Post-dosing on Day 15
NCT02433834 (7) [back to overview]Change From Baseline in Asthma Control Questionnaire (ACQ-5) on Day 15
NCT02433834 (7) [back to overview]FEV1 AUC0-3 on Day 15
NCT02433834 (7) [back to overview]Change From Baseline in Average Daily Post-dose PEFR Over 14 Days
NCT02433834 (7) [back to overview]Change From Baseline in Average Daily Pre-dose PEFR Over 14 Days
NCT02433834 (7) [back to overview]Change From Baseline in Average Daily Rescue Medication Use Over 14 Days
NCT02433834 (7) [back to overview]Change From Baseline in Morning Pre-dose Trough FEV1 on Day 15
NCT02487446 (8) [back to overview]Change From Baseline in FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h
NCT02487446 (8) [back to overview]Change From Baseline in FEV1 AUC 0-12h
NCT02487446 (8) [back to overview]Change From Baseline in Trough FEV1 (Mean of 23h 15 Minutes and 23 h 45 Minutes Post Previous Morning Dose)
NCT02487446 (8) [back to overview]Change From Baseline in Pre-dose Trough FEV1 (Mean of 15 Minutes and 45 Minutes Pre Morning Dose)
NCT02487446 (8) [back to overview]Change From Baseline in Forced Expiratory Volume (FEV1) Area Under the Curve (AUC) 0-24h
NCT02487446 (8) [back to overview]Change From Baseline in FEV1 AUC 12-24h
NCT02487446 (8) [back to overview]QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Forced Vital Capacity (FVC) at Any Time Point
NCT02487446 (8) [back to overview]QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in FEV1 at Any Time Point
NCT02487498 (8) [back to overview]Change From Baseline in FEV1 AUC 0-12h
NCT02487498 (8) [back to overview]Change From Baseline in FEV1 AUC 12-24h
NCT02487498 (8) [back to overview]Change From Baseline in Forced Expiratory Volume (FEV1) Area Under the Curve (AUC) 0-24h
NCT02487498 (8) [back to overview]QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Pre-dose Trough FEV1 (Mean of 15 Minutes and 45 Minutes Pre Morning Dose)
NCT02487498 (8) [back to overview]Superiority of QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Trough FEV1 (Mean of 23h 15 Minutes and 23 h 45 Minutes Post Previous Morning Dose)
NCT02487498 (8) [back to overview]Change From Baseline in FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h
NCT02487498 (8) [back to overview]QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in FEV1 at Any Time Point
NCT02487498 (8) [back to overview]QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Forced Vital Capacity (FVC) at Any Time Point
NCT02512302 (18) [back to overview]Apparent Volume of Distribution (Vz/F) After Extravascular Dose Administration of Seebri Breezhaler and SUN-101
NCT02512302 (18) [back to overview]Area Under the Curve From Time Zero to 24 Hours (AUC0_24)
NCT02512302 (18) [back to overview]Area Under the Curve Zero to 48 Hours (AUC0_48) for Seebri Breezhaler and Sun-101 AUC0-48, CL/F, Vz/F, Tmax, t½, and Dose Normalized Cmax, AUC0-24, AUC0-48, AUC0-∞ - AUC0-∞ -
NCT02512302 (18) [back to overview]Clearance (CL) for IV Infusion of 50 mcg of Glycopyrrolate
NCT02512302 (18) [back to overview]Cmax
NCT02512302 (18) [back to overview]Time of Occurrence of Cmax (Tmax) for IV Infusion of 50 mcg of Glycopyrrolate
NCT02512302 (18) [back to overview]Dose Normalized Area Under the Curve Zero From Zero to Infinity (AUC0_inf) for Seebri and SUN-101
NCT02512302 (18) [back to overview]Dose Normalized Area Under the Curve Zero to 48 Hours (AUC0_48) for Seebri and SUN-101
NCT02512302 (18) [back to overview]Dose Normalized Cmax for Seebri and SUN-101.
NCT02512302 (18) [back to overview]Area Under the Curve From Time Zero to Infinity (AUC0_infinity)
NCT02512302 (18) [back to overview]Dose Normalized Area Under the Curve Zero to 24 Hours (AUC0_24) for Seebri and SUN-101
NCT02512302 (18) [back to overview]The Percentage of Subjects With Adverse Events (AEs), Serious Adverse Events (SAEs), and AEs Leading to Discontinuation
NCT02512302 (18) [back to overview]The Number of Subjects With Adverse Events (AEs), Serious Adverse Events (SAEs), and AEs Leading to Discontinuation
NCT02512302 (18) [back to overview]Time of Occurrence of Cmax (Tmax) for Seebri Breezhaler and SUN-101
NCT02512302 (18) [back to overview]Volume of Distribution During the Elimination Phase (Vz) for IV Infusion of 50 mcg of Glycopyrrolate
NCT02512302 (18) [back to overview]Terminal Half Life (t1/2) for for Seebri Breezhaler and SUN-101
NCT02512302 (18) [back to overview]Terminal Half Life (t1/2) for IV Infusion of 50 mcg of Glycopyrrolate
NCT02512302 (18) [back to overview]Apparent Clearance Calculated as Dose/AUC0-INF After Extravascular Dose Administration of Seebri Breezhaler and SUN-101
NCT02524145 (2) [back to overview]Central Command Regulation of Heart Rate
NCT02524145 (2) [back to overview]Cardiac Beta-receptor Sensitivity
NCT02530281 (6) [back to overview]Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4
NCT02530281 (6) [back to overview]Percentage of Subjects Who Have a ≥2 Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS) From Baseline at Week 4
NCT02530281 (6) [back to overview]Median Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4
NCT02530281 (6) [back to overview]Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4, Excluding Centers With Outlier Data
NCT02530281 (6) [back to overview]Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4
NCT02530281 (6) [back to overview]Percentage of Subjects Who Have a ≥4-point Improvement in the Weekly Mean Score of ASDD Item #2 From Baseline at Week 4
NCT02530294 (5) [back to overview]Median Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4
NCT02530294 (5) [back to overview]Percentage of Subjects Who Have a ≥2 Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS) From Baseline at Week 4
NCT02530294 (5) [back to overview]Percentage of Subjects Who Have a ≥4-point Improvement in the Weekly Mean Score of Axillary Sweating Daily Diary (ASDD) Item #2 From Baseline at Week 4
NCT02530294 (5) [back to overview]Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4
NCT02530294 (5) [back to overview]Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4
NCT02553798 (4) [back to overview]Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 44/ET
NCT02553798 (4) [back to overview]Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4
NCT02553798 (4) [back to overview]Long-term Safety Assessed Through Adverse Events and Local Skin Reactions
NCT02553798 (4) [back to overview]Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS)
NCT02566031 (5) [back to overview]Baseline Transitional Dyspnea Index (TDI) Focal Score
NCT02566031 (5) [back to overview]Daily Rescue Medication Use (Number of Puffs)
NCT02566031 (5) [back to overview]Trough Forced Expiratory Volume In One Second (FEV1) After 12 Weeks of Treatment
NCT02566031 (5) [back to overview]Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
NCT02566031 (5) [back to overview]Trough Forced Expiratory Volume In One Second (FEV1) After 4 Weeks of Treatment
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 75 mmHg
NCT02726620 (43) [back to overview]Usage Frequency of Cardiovascular Drugs: Ephinephrine
NCT02726620 (43) [back to overview]Usage Frequency of Cardiovascular Drugs: Ephedrine
NCT02726620 (43) [back to overview]Timing of Cardiovascular Drugs for MAP < 65 mmHg
NCT02726620 (43) [back to overview]Postoperative Rise in Creatinine Levels
NCT02726620 (43) [back to overview]Time to Discharge Readiness at the Postanesthesia Care Unit (PACU)
NCT02726620 (43) [back to overview]Timing of Cardiovascular Drugs for MAP < 50 mmHg
NCT02726620 (43) [back to overview]Timing of Cardiovascular Drugs for MAP < 55 mmHg
NCT02726620 (43) [back to overview]Timing of Cardiovascular Drugs for MAP < 60 mmHg
NCT02726620 (43) [back to overview]Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 65 mmHg
NCT02726620 (43) [back to overview]Incidence of a MAP < 50 mmHg for > 20 Minutes
NCT02726620 (43) [back to overview]Incidence of a MAP < 55 mmHg
NCT02726620 (43) [back to overview]Incidence of a MAP < 50 mmHg for > 10 Minutes
NCT02726620 (43) [back to overview]Incidence of a MAP < 55 mmHg for > 10 Minutes
NCT02726620 (43) [back to overview]Incidence of a MAP < 55 mmHg for > 20 Minutes
NCT02726620 (43) [back to overview]Incidence of a MAP < 60 mmHg
NCT02726620 (43) [back to overview]Incidence of a MAP < 60 mmHg for > 10 Minutes
NCT02726620 (43) [back to overview]Incidence of a MAP < 60 mmHg for > 20 Minutes
NCT02726620 (43) [back to overview]Intraoperative Administration of Intravenous Fluids
NCT02726620 (43) [back to overview]Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 50 mmHg
NCT02726620 (43) [back to overview]Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 55 mmHg
NCT02726620 (43) [back to overview]Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 60 mmHg
NCT02726620 (43) [back to overview]Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 65 mmHg
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 55 mmHg
NCT02726620 (43) [back to overview]Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 60 mmHg
NCT02726620 (43) [back to overview]Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 55 mmHg
NCT02726620 (43) [back to overview]Incidence of a MAP < 50 mmHg
NCT02726620 (43) [back to overview]In-hospital Mortality
NCT02726620 (43) [back to overview]Estimated Intraoperative Blood Loss
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 70 mmHg
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 65 mmHg
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 60 mmHg
NCT02726620 (43) [back to overview]Depth and Duration of Intraoperative Hypotension - Threshold MAP 50 mmHg
NCT02726620 (43) [back to overview]Average Use of Cardiovascular Drugs: Phenylephrine
NCT02726620 (43) [back to overview]Average Use of Cardiovascular Drugs: Norepinephrine
NCT02726620 (43) [back to overview]Average Use of Cardiovascular Drugs: Glycopyrrolate
NCT02726620 (43) [back to overview]Average Use of Cardiovascular Drugs: Epinephrine
NCT02726620 (43) [back to overview]Average Use of Cardiovascular Drugs: Ephedrine
NCT02726620 (43) [back to overview]30-day Mortality
NCT02726620 (43) [back to overview]Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 50 mmHg
NCT02726620 (43) [back to overview]Usage Frequency of Cardiovascular Drugs: Phenylephrine
NCT02726620 (43) [back to overview]Usage Frequency of Cardiovascular Drugs: Norepinephrine
NCT02726620 (43) [back to overview]Usage Frequency of Cardiovascular Drugs: Glycopyrrolate
NCT02860507 (2) [back to overview]Operating Room (OR) Turnover Time When Using Sugammadex Instead of Combination of Neostigmine and Glycopyrrolate.
NCT02860507 (2) [back to overview]Number of Patients Who Experience Postoperative Nausea and Vomiting, Post-operative Pain, and Post-operative Complications
NCT02867761 (14) [back to overview]Treatment Failure Defined by Increase in Lower Respiratory Symptoms Necessitating Treatment With Active, Long-acting Inhaled Bronchodilator, Corticosteroids or Antibiotics
NCT02867761 (14) [back to overview]Proportion of Individuals With Both a 4 Unit Improvement in SGRQ and a 1 Unit Improvement in BDI/TDI Without Treatment Failure
NCT02867761 (14) [back to overview]Proportion of Individuals With a 2 Unit Improvement in CAT Without Treatment Failure
NCT02867761 (14) [back to overview]Proportion of Individuals With a 1 Unit Improvement in the BDI/TDI Without Treatment Failure
NCT02867761 (14) [back to overview]Proportion (Percentage) of Individuals Who Experience a 4 Unit Improvement in St. George's Respiratory Questionnaire (SGRQ) at 12 Weeks and do Not Meet Criteria for Treatment Failure During the 12 Week Treatment Period
NCT02867761 (14) [back to overview]Mean Change in COPD Assessment Test (CAT)
NCT02867761 (14) [back to overview]Mean Change in St. George's Respiratory Questionnaire (SGRQ)
NCT02867761 (14) [back to overview]Symptoms and Rescue Medication Use Based on Daily Diary
NCT02867761 (14) [back to overview]Area Under the Curve (AUC) 0-3 Hours for FEV1
NCT02867761 (14) [back to overview]Change in FEF25-75%
NCT02867761 (14) [back to overview]Change From Baseline in 12 Hour Trough Inspiratory Capacity - Absolute Value
NCT02867761 (14) [back to overview]Change From Baseline in Trough FEV1 - % Predicted
NCT02867761 (14) [back to overview]Change From Baseline in Trough Forced Expiratory Volume Per 1 Second (FEV1) - Absolute Value
NCT02867761 (14) [back to overview]Mean Change in Baseline Dyspnea Index (BDI)/Transition Dyspnea Index (TDI)
NCT02872935 (2) [back to overview]Number of Participants Who Reported Nausea
NCT02872935 (2) [back to overview]Number of Participants Who Experienced Vomiting.
NCT02948582 (15) [back to overview]Number of Subjects With Clinically Significant ECG Parameters Reported During the Study
NCT02948582 (15) [back to overview]Percentage of Subjects With Treatment Emergent AEs
NCT02948582 (15) [back to overview]t1/2; Plasma Half-life
NCT02948582 (15) [back to overview]Tmax; Time to Maximum Observed Plasma Concentration
NCT02948582 (15) [back to overview]Trough FEV1 (Change From Baseline)
NCT02948582 (15) [back to overview]Number of Subjects Who Died, Number of Subjects With Treatment Emergent SAEs, Number of Subjects Who Discontinued Due to AE
NCT02948582 (15) [back to overview]Peak FEV1 (Change From Baseline and Percent Change)
NCT02948582 (15) [back to overview]Standardized FEV1 AUC0-24 Area Under the FEV1 Curve From 0 to 24 Hours Post-dose (Actual and Change Baseline)
NCT02948582 (15) [back to overview]AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity
NCT02948582 (15) [back to overview]Standardized FEV1AUC12-24 Area Under the FEV1 Curve From 12 to 24 Hours Post- Dose (Actual and Change From Baseline).
NCT02948582 (15) [back to overview]Standardized FEV1AUC0-12 Area Under the FEV1 Curve From 0 to 12 Hours Post-dose ( Actual and Change From Baseline).
NCT02948582 (15) [back to overview]Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study
NCT02948582 (15) [back to overview]Number of Clinically Significant Abnormal Laboratory Results Reported During the Study
NCT02948582 (15) [back to overview]Cmax; Maximum Observed Plasma Concentration
NCT02948582 (15) [back to overview]AUC0-t; Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Measurable Drug Concentration.
NCT02951312 (18) [back to overview]Number of Subjects With Treatment Emergent AEs
NCT02951312 (18) [back to overview]Number of Subjects Who Discontinued Due to AE
NCT02951312 (18) [back to overview]Number of Subjects With Clinically Significant Abnormal Laboratory Results Reported During the Study
NCT02951312 (18) [back to overview]Number of Subjects With Clinically Significant Abnormal Laboratory Results Reported During the Study
NCT02951312 (18) [back to overview]Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study
NCT02951312 (18) [back to overview]Number of Subjects With Clinically Significant ECG Parameters Reported During the Study
NCT02951312 (18) [back to overview]Number of Subjects Who Died
NCT02951312 (18) [back to overview]Peak FEV1 (Change From Baseline )
NCT02951312 (18) [back to overview]Number of Subjects With Treatment Emergent SAEs
NCT02951312 (18) [back to overview]Peak FEV1 (Percent Change)
NCT02951312 (18) [back to overview]Percentage of Subjects With Treatment Emergent AEs
NCT02951312 (18) [back to overview]t1/2 Plasma Half-life
NCT02951312 (18) [back to overview]Tmax Time to Maximum Observed Plasma Concentration
NCT02951312 (18) [back to overview]Trough FEV1 (Change From Baseline)
NCT02951312 (18) [back to overview]FEV1 AUC0-24 Area Under the FEV1 Over Time Curve (Change From Baseline)
NCT02951312 (18) [back to overview]Cmax Maximum Observed Plasma Concentration
NCT02951312 (18) [back to overview]AUC0-t Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration
NCT02951312 (18) [back to overview]AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity
NCT02996591 (16) [back to overview]Numerical Rating Scale (NRS) Pain Scores at 1 Hour Postop
NCT02996591 (16) [back to overview]Numerical Rating Scale Pain Scores at 2 Hours Postop
NCT02996591 (16) [back to overview]Numerical Rating Scale Pain Scores on Postoperative Day (POD) 1
NCT02996591 (16) [back to overview]Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)
NCT02996591 (16) [back to overview]Opioid-Related Symptom Distress Scale (ORSDS) Score
NCT02996591 (16) [back to overview]Time Until Patient is Ready for Discharge From Post-Anesthesia Care Unit (PACU) to Home.
NCT02996591 (16) [back to overview]Back Pain on POD1
NCT02996591 (16) [back to overview]Opioid Consumption
NCT02996591 (16) [back to overview]Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)
NCT02996591 (16) [back to overview]Cognitive Recovery at 2 Hours Post-operative
NCT02996591 (16) [back to overview]Cognitive Recovery on POD1
NCT02996591 (16) [back to overview]Incidence of Transient Neurologic Symptoms
NCT02996591 (16) [back to overview]Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)
NCT02996591 (16) [back to overview]Assessment of Patient Blinding to Group Assignment
NCT02996591 (16) [back to overview]Opioid Consumption Through First Postoperative Day. Measured in mg OME
NCT02996591 (16) [back to overview]Nausea Intensity
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Budesonide
NCT03075267 (42) [back to overview]Terminal Elimination Rate Constant (λz) - Glycopyrronium
NCT03075267 (42) [back to overview]Terminal Elimination Rate Constant (λz) - Formoterol
NCT03075267 (42) [back to overview]Terminal Elimination Rate Constant (λz) - Budesonide
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Glycopyrronium
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Glycopyrronium
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Formoterol
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Formoterol
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Budesonide
NCT03075267 (42) [back to overview]Maximum Plasma Concentration (Cmax) - Budesonide
NCT03075267 (42) [back to overview]Elimination Half-life (t½) - Glycopyrronium
NCT03075267 (42) [back to overview]Elimination Half-life (t½) - Formoterol
NCT03075267 (42) [back to overview]Elimination Half-life (t½) - Budesonide
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Glycopyrronium
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Glycopyrronium
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Formoterol
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Formoterol
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Budesonide
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Budesonide
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Glycopyrronium
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Formoterol
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Budesonide
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Formoterol
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Budesonide
NCT03075267 (42) [back to overview]Apparent Volume of Distribution (Vd/F) - Glycopyrronium
NCT03075267 (42) [back to overview]Apparent Volume of Distribution (Vd/F) - Formoterol
NCT03075267 (42) [back to overview]Apparent Volume of Distribution (Vd/F) - Budesonide
NCT03075267 (42) [back to overview]Apparent Total Body Clearance (CL/F) - Glycopyrronium
NCT03075267 (42) [back to overview]Apparent Total Body Clearance (CL/F) - Formoterol
NCT03075267 (42) [back to overview]Apparent Total Body Clearance (CL/F) - Budesonide
NCT03075267 (42) [back to overview]Accumulation Ratio for Cmax (RAC [Cmax]) - Glycopyrronium
NCT03075267 (42) [back to overview]Accumulation Ratio for Cmax (RAC [Cmax]) - Formoterol
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium
NCT03075267 (42) [back to overview]Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Glycopyrronium
NCT03075267 (42) [back to overview]Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Formoterol
NCT03075267 (42) [back to overview]Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Budesonide
NCT03075267 (42) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Glycopyrronium
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Formoterol
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Formoterol
NCT03075267 (42) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Budesonide
NCT03075267 (42) [back to overview]Accumulation Ratio for Cmax (RAC [Cmax]) - Budesonide
NCT03116997 (1) [back to overview]Measure Participants' Recovery Time Post-Surgery
NCT03137784 (10) [back to overview]Peak FEV1 During 4 Hours Post-dose After 1 Week of Treatment
NCT03137784 (10) [back to overview]FEV1 AUC (5 Min - 23 h 45 Min) After One Week of Treatment
NCT03137784 (10) [back to overview]FEV1 AUC (5 Min-1 h) After One Week of Treatment
NCT03137784 (10) [back to overview]FEV1 AUC (5 Min-4 h) After One Week of Treatment
NCT03137784 (10) [back to overview]Percent Change From Baseline in FEV1/FVC Ratio
NCT03137784 (10) [back to overview]Trough FEV1 After One Week of Treatment, Point Estimate
NCT03137784 (10) [back to overview]Mean Morning Peak Expiratory Flow (PEF) Following the 1-week Treatment Period
NCT03137784 (10) [back to overview]Mean Evening Peak Expiratory Flow Rate (PEF) Following 1-week Treatment
NCT03137784 (10) [back to overview]Trough Forced Vital Capacity (FVC) After 1 Week of Treatment
NCT03137784 (10) [back to overview]Mean Daily Number of Puffs of Rescue Medication During 1 Week of Treatment
NCT03138967 (3) [back to overview]Overall Recovery Time
NCT03138967 (3) [back to overview]PostOperative Complications
NCT03138967 (3) [back to overview]Muscle Recovery Time
NCT03162055 (10) [back to overview]Mean Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks in FAS Population
NCT03162055 (10) [back to overview]Mean Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks in PP Analysis Set Population
NCT03162055 (10) [back to overview]Mean Peak Change From Baseline in Inspiratory Capacity (IC) Within 2 Hours Post-dosing Over 24 Weeks
NCT03162055 (10) [back to overview]Mean Transition Dyspnea Index (TDI) Focal Score Over 24 Weeks
NCT03162055 (10) [back to overview]Percentage of Participants With Increase of FEV1 of >=100 mL From Baseline at 5 Minutes Post-dosing on Day 1
NCT03162055 (10) [back to overview]Mean Change From Baseline in COPD Assessment Test (CAT) Score Over 24 Weeks
NCT03162055 (10) [back to overview]Mean Change From Baseline in Daily Rescue (Albuterol/Salbutamol MDI) Use Over 24 Weeks
NCT03162055 (10) [back to overview]Mean Change From Baseline in Early Morning Symptoms of COPD Instrument (EMSCI) Over 24 Weeks
NCT03162055 (10) [back to overview]Mean Change From Baseline in Morning Pre-dose Trough Forced Expiratory Volume in 1 Second (FEV1) Over 24 Weeks
NCT03162055 (10) [back to overview]Mean Change From Baseline in Night-Time Symptoms of COPD Instrument (NiSCI) Over 24 Weeks
NCT03168308 (3) [back to overview]Number of Hypoxic Episodes
NCT03168308 (3) [back to overview]Number of Participants Who Needed Rescue Sugammadex After Initial Reversal of Neuromuscular Blockade
NCT03168308 (3) [back to overview]Time to Complete Reversal of Neuromuscular Blockade
NCT03229486 (7) [back to overview]Time to Regular Breathing
NCT03229486 (7) [back to overview]Pediatric Anesthesia Emergence Delirium Score
NCT03229486 (7) [back to overview]Time Recovery of TOF Ratio to 0.7
NCT03229486 (7) [back to overview]Time Recovery of TOF Ratio to 0.8
NCT03229486 (7) [back to overview]Time Recovery of TOF Ratio to 0.9
NCT03229486 (7) [back to overview]Time to Awakening
NCT03229486 (7) [back to overview]Time to Extubation
NCT03250182 (21) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium
NCT03250182 (21) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Formoterol
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Budesonide
NCT03250182 (21) [back to overview]Time to Maximum Plasma Concentration (Tmax) - Budesonide
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Glycopyrronium
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Glycopyrronium
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Formoterol
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Formoterol
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Budesonide
NCT03250182 (21) [back to overview]Maximum Plasma Concentration (Cmax) - Budesonide
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Glycopyrronium
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Budesonide
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Formoterol
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Budesonide
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Glycopyrronium
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Formoterol
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Budesonide
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Glycopyrronium
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Glycopyrronium
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Formoterol
NCT03250182 (21) [back to overview]Area Under the Plasma Concentration-time Curve (AUC 0-12) - Formoterol
NCT03256552 (4) [back to overview]Morning Pre-dose Trough FEV1
NCT03256552 (4) [back to overview]Peak Change in FEV1
NCT03256552 (4) [back to overview]FVC AUC0-2
NCT03256552 (4) [back to overview]FEV1 AUC0-2
NCT03322657 (5) [back to overview]Change of Diaphragmatic Contractility Speed- Sniff (Breathing From the Nose), cm/s
NCT03322657 (5) [back to overview]Change of Diaphragmatic Contractility Speed, Deep Breathing From Mouth, cm/s
NCT03322657 (5) [back to overview]TOF Ratio at 90 Min
NCT03322657 (5) [back to overview]Time in Minutes to Reach Train of Four (TOF) Ratio ≥ 0.9 After the Administration of Reversal Agent
NCT03322657 (5) [back to overview]The Time for Extubation After Administration of Reversal Agents
NCT03346057 (6) [back to overview]Percentage of Participants Experiencing an Event of Clinical Interest (ECI) Up To 7 Days After Administration of Study Intervention
NCT03346057 (6) [back to overview]Percentage of Participants Experiencing a Serious Adverse Event (SAE) Up To 7 Days After Administration of Study Intervention
NCT03346057 (6) [back to overview]Percentage of Participants Experiencing an Adverse Event (AE) Up To 7 Days After Administration of Study Intervention
NCT03346057 (6) [back to overview]Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events
NCT03346057 (6) [back to overview]Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events
NCT03346057 (6) [back to overview]Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events
NCT03346070 (11) [back to overview]Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events
NCT03346070 (11) [back to overview]Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events
NCT03346070 (11) [back to overview]Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis
NCT03346070 (11) [back to overview]Percentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention
NCT03346070 (11) [back to overview]Percentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.9
NCT03346070 (11) [back to overview]Percentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention
NCT03346070 (11) [back to overview]Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events
NCT03346070 (11) [back to overview]Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis
NCT03346070 (11) [back to overview]Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis
NCT03346070 (11) [back to overview]Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis
NCT03346070 (11) [back to overview]Percentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention
NCT03351608 (9) [back to overview]Plasma Half-Life (t½) of Sugammadex [Part A]
NCT03351608 (9) [back to overview]Time to Recovery of Participant Train-of-Four (TOF) Ratio to ≥0.9 [Part B]
NCT03351608 (9) [back to overview]Time to Recovery of Participant TOF Ratio to ≥0.7 [Part B]
NCT03351608 (9) [back to overview]Time to Recovery of Participant TOF Ratio to ≥0.8 [Part B]
NCT03351608 (9) [back to overview]Plasma Clearance (CL) of Sugammadex [Part A]
NCT03351608 (9) [back to overview]Percentage of Participants With ≥1 Adverse Event (AE) [Parts A and B]
NCT03351608 (9) [back to overview]Maximum Plasma Concentration (Cmax) of Sugammadex [Part A]
NCT03351608 (9) [back to overview]Area Under the Plasma Concentration-Time Curve (AUC) From Dosing to Infinity (AUC0-∞) of Sugammadex [Part A]
NCT03351608 (9) [back to overview]Apparent Volume of Distribution (Vz) of Sugammadex [Part A]
NCT03357393 (7) [back to overview]Assessment of Self-rated Patient Questionaries' Using S-PSR
NCT03357393 (7) [back to overview]Bronchoscopist Evaluation Using a Likert-type Scale
NCT03357393 (7) [back to overview]Discharge Assessment Using PADSS After 2 Hours Number of Patients Reaching PADSS Score 10 After 2 Hours
NCT03357393 (7) [back to overview]Level of Sedation Using the Observer's Assessment of Alertness/Sedation (OAA/S) Scale
NCT03357393 (7) [back to overview]Number of Participants With Interventions Performed
NCT03357393 (7) [back to overview]Patients' Satisfaction Using a Likert-type Scale
NCT03357393 (7) [back to overview]Quality of Recovery (QoR-23)
NCT03513757 (13) [back to overview]Oral/Enteral Intake
NCT03513757 (13) [back to overview]Nitrous Oxide
NCT03513757 (13) [back to overview]Lidocaine Dose
NCT03513757 (13) [back to overview]Irritability
NCT03513757 (13) [back to overview]Delirium
NCT03513757 (13) [back to overview]Dexmedetomidine Dose
NCT03513757 (13) [back to overview]Discharge Ready
NCT03513757 (13) [back to overview]Efficiency of Propofol Dexmedetomidine Sedation Compared With Propofol Infusion
NCT03513757 (13) [back to overview]Eye Opening
NCT03513757 (13) [back to overview]Glycopyrrolate Dose
NCT03513757 (13) [back to overview]Total Propofol Administered
NCT03513757 (13) [back to overview]Sevoflurane
NCT03513757 (13) [back to overview]Sleep Pattern
NCT03742141 (1) [back to overview]Frequency of Congruence of Nerve Integrity and Vocal Cord Functions
NCT03880266 (5) [back to overview]Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically-measured Sweat Production From Baseline at Week 2
NCT03880266 (5) [back to overview]Percentage of Subjects Who Have a ≥2 Grade Improvement in HDSS (Hyperhidrosis Disease Severity Scale) From Baseline at Week 2
NCT03880266 (5) [back to overview]Mean Percent Change From Baseline in Gravimetrically-measured Sweat Production at Week 2
NCT03880266 (5) [back to overview]Mean Change From Baseline to Week 2 in Hand Sweating Severity Score
NCT03880266 (5) [back to overview]Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 2
NCT03939923 (5) [back to overview]Heart Rate
NCT03939923 (5) [back to overview]Blood Pressure (First Measurement of Systolic Blood Pressure Post Reversal)
NCT03939923 (5) [back to overview]Peak Flow Rate
NCT03939923 (5) [back to overview]Tidal Volume
NCT03939923 (5) [back to overview]Time to Extubation

Number of Participants With Clinical Signs of Recovery Assessed by Level of Consciousness, Head Lift and Muscle Weakness, Prior to Transfer to the Recovery Room After Extubation

After anesthesia and prior to transfer to the recovery room after extubation, neuromuscular recovery was assessed by monitoring every 15 minutes the following clinical signs of recovery: level of consciousness (i.e., awake and oriented, arousable with minimal stimulation, responsive only to tactile stimulation); 5-second head lift test (ability to lift the head for 5 seconds); and general muscle weakness (NCT00451217)
Timeframe: Day 1

,,,
InterventionParticipants (Count of Participants)
Consciousness: Awake and orientedConsciousness: Arousable with minimal stimulationConsciousness: Responsive only to tactile stimuliAble to perform the 5 second head liftHas general muscle weakness
Rocuronium + Neostigmine35130379
Rocuronium + Sugammadex30162383
Vecuronium + Neostigmine26145326
Vecuronium + Sugammadex29172404

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8

Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.8 indicates a faster recovery from NMB. (NCT00451217)
Timeframe: Day 1: From start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.8

InterventionMinutes (Mean)
Rocuronium + Sugammadex1.32
Rocuronium + Neostigmine15.32
Vecuronium + Sugammadex2.12
Vecuronium + Neostigmine15.33

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Number of Participants With Clinical Signs of Recovery Assessed by Level of Consciousness, Head Lift and Muscle Weakness, Prior to Discharge From the Recovery Room

Just prior to discharge from the recovery room, neuromuscular recovery was assessed by monitoring every 15 minutes the following clinical signs of recovery: level of consciousness (i.e., awake and oriented, arousable with minimal stimulation, responsive only to tactile stimulation); 5-second head lift test (ability to lift the head for 5 seconds); and general muscle weakness (NCT00451217)
Timeframe: Day 1

,,,
InterventionParticipants (Count of Participants)
Consciousness: Awake and orientedConsciousness: Arousable with minimal stimulationConsciousness: Responsive only to tactile stimuliAble to perform the 5 second head liftHas general muscle weakness
Rocuronium + Neostigmine4800480
Rocuronium + Sugammadex4610470
Vecuronium + Neostigmine4310440
Vecuronium + Sugammadex4800480

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the Fourth Twitch/First Twitch (T4/T1) Ratio to 0.9.

Neuromuscular functioning was monitored by applying repetitive Train-Of-Four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from neuromuscular blockade (NMB). In this study, twitch responses were recorded until the T4/T1 Ratio reached >= 0.9, the minimum acceptable ratio that indicated recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.9 indicates a faster recovery from NMB. (NCT00451217)
Timeframe: Day 1: From start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.9

InterventionMinutes (Mean)
Rocuronium + Sugammadex1.62
Rocuronium + Neostigmine26.78
Vecuronium + Sugammadex4.47
Vecuronium + Neostigmine23.43

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7

Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.7 indicates a faster recovery from NMB. (NCT00451217)
Timeframe: Day 1: From start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.7

InterventionMinutes (Mean)
Rocuronium + Sugammadex1.17
Rocuronium + Neostigmine9.60
Vecuronium + Sugammadex1.68
Vecuronium + Neostigmine9.52

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.9 After Neuromuscular Block (NMB) Induced by Vecuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.9 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.9. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.9 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 6 hours after administration of study drug

InterventionMinutes (Mean)
Vecuronium+Sugammadex8.73
Vecuronium+Neostigmine77.80

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Number of Participants Able to Perform a 5-second Head Lift

The number of participants who were able to lift their head for 5 seconds was assessed by the investigator as a measure of recovery from NMB at 2 timepoints: prior to transfer to the recovery room after extubation and prior to discharge from the recovery room. The assessment was performed every 15 minutes until the first successful 5-second head lift was achieved. Participants who were not cooperative with the examination were not included in the assessment. (NCT00473694)
Timeframe: Up to 24 hours

,,,
InterventionParticipants (Count of Participants)
Prior to transfer to recovery roomPrior to discharge from recovery room
Rocuronium+Neostigmine2833
Rocuronium+Sugammadex3334
Vecuronium+Neostigmine2433
Vecuronium+Sugammadex3641

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Number of Participants Aroused With Minimal Stimulation After Anesthesia (Clinical Assessment of Level of Consciousness)

The number of participants aroused with minimal stimulation was assessed as part of an overall assessment of the clinical level of consciousness by the investigator. The clinical level of consciousness was used as a measure of recovery from NMB at 2 timepoints: prior to transfer to the recovery room after extubation and prior to discharge from the recovery room. Attempts were made to arouse participants every 15 minutes with mild prodding, mild shaking, and asking questions regarding name, location, and day of the week. The assessment ended once the participant was awake and fully orientated, 24 hours, or discharged from the hospital if discharge occurs before 24 hours; whichever occurred first. Participants were given a level of consciousness based on what type of stimulation they responded to. Participants who were not cooperative with the examination were not included in the assessment. (NCT00473694)
Timeframe: Up to 24 hours

,,,
InterventionParticipants (Count of Participants)
Prior to transfer to recovery roomPrior to discharge from recovery room
Rocuronium+Neostigmine111
Rocuronium+Sugammadex90
Vecuronium+Neostigmine81
Vecuronium+Sugammadex122

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Number of Participants Responsive Only to Tactile Stimulation After Anesthesia (Clinical Assessment of Level of Consciousness)

The number of participants responsive only to tactile stimulation was assessed as part of an overall assessment of the clinical level of consciousness by the investigator. The clinical level of consciousness was used as a measure of recovery from NMB at 2 timepoints: prior to transfer to the recovery room after extubation and prior to discharge from the recovery room. Attempts were made to arouse participants every 15 minutes with mild prodding, mild shaking, and asking questions regarding name, location, and day of the week. The assessment ended once the participant was awake and fully orientated, 24 hours, or discharged from the hospital if discharge occurs before 24 hours; whichever occurred first. Participants were given a level of consciousness based on what type of stimulation they responded to. Participants who were not cooperative with the examination were not included in the assessment. (NCT00473694)
Timeframe: Up to 24 hours

,,,
InterventionParticipants (Count of Participants)
Prior to transfer to recovery roomPrior to discharge from recovery room
Rocuronium+Neostigmine30
Rocuronium+Sugammadex20
Vecuronium+Neostigmine70
Vecuronium+Sugammadex70

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Number of Participants Awake and Oriented After Anesthesia (Clinical Assessment of Level of Consciousness)

The number of participants who were awake and oriented was assessed as part of an overall assessment of the clinical level of consciousness by the investigator. The clinical level of consciousness was used as a measure of recovery from NMB at 2 timepoints: prior to transfer to the recovery room after extubation and prior to discharge from the recovery room. Attempts were made to arouse participants every 15 minutes with mild prodding, mild shaking, and asking questions regarding name, location, and day of the week. The assessment ended once the participant was awake and fully orientated, 24 hours, or discharged from the hospital if discharge occurs before 24 hours; whichever occurred first. Participants were given a level of consciousness based on what type of stimulation they responded to. Participants who were not cooperative with the examination were not included in the assessment. (NCT00473694)
Timeframe: Up to 24 hours

,,,
InterventionParticipants (Count of Participants)
Prior to transfer to recovery roomPrior to discharge from recovery room
Rocuronium+Neostigmine2032
Rocuronium+Sugammadex2634
Vecuronium+Neostigmine2033
Vecuronium+Sugammadex2739

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Number of Participants Experiencing General Muscle Weakness

The number of participants experiencing general muscle weakness was assessed by the investigator as a measure of recovery from NMB at 2 timepoints: prior to transfer to the recovery room after extubation and prior to discharge from the recovery room. The assessments were performed every 15 minutes until the absence of general muscle weakness. A standardized examination form was used to determine the presence or absence of muscle weakness in various muscle groups. Participants who were not cooperative with the examination were not included in the assessment. (NCT00473694)
Timeframe: Up to 24 hours

,,,
InterventionParticipants (Count of Participants)
Prior to transfer to recovery roomPrior to discharge from recovery room
Rocuronium+Neostigmine53
Rocuronium+Sugammadex32
Vecuronium+Neostigmine23
Vecuronium+Sugammadex41

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7 After Neuromuscular Block (NMB) Induced by Rocuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.7 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.7. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.7 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 2 hours after administration of study drug

InterventionMinutes (Mean)
Rocuronium+Sugammadex2.27
Rocuronium+Neostigmine37.68

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.7 After Neuromuscular Block (NMB) Induced by Vecuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.7 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.7. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.7 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 4 hours after administration of study drug

InterventionMinutes (Mean)
Vecuronium+Sugammadex4.10
Vecuronium+Neostigmine56.17

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8 After Neuromuscular Block (NMB) Induced by Rocuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.8 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.8. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.8 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 3 hours after administration of study drug

InterventionMinutes (Mean)
Rocuronium+Sugammadex2.65
Rocuronium+Neostigmine45.82

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.8 After Neuromuscular Block (NMB) Induced by Vecuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.8 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.8. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.8 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 5 hours after administration of study drug

InterventionMinutes (Mean)
Vecuronium+Sugammadex5.55
Vecuronium+Neostigmine67.42

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Time From Start of Administration of Sugammadex or Neostigmine to Recovery of the T4/T1 Ratio to 0.9 After Neuromuscular Block (NMB) Induced by Rocuronium

Mean time from start of sugammadex or neostigmine administration to recovery of T4/T1 ratio to 0.9 was assessed by applying repetitive train of four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. Nerve stimulation continued until the ratio of the magnitude of the fourth twitch (T4) to first twitch (T1) reached at least 0.9. The greater the T4/T1 ratio represented the greater the recovery from NMB; with a value of 0.0 representing no recovery and 1.0 representing full recovery. Reduced recovery time of the T4/T1 ratio to 0.9 indicated faster recovery from NMB. Mean time was collected in minutes and seconds but converted to and presented in minutes only. The analysis included a procedure for the imputation of missing recovery times. (NCT00473694)
Timeframe: Up to approximately 3 hours after administration of study drug

InterventionMinutes (Mean)
Rocuronium+Sugammadex3.28
Rocuronium+Neostigmine55.50

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Proportion of Responders According to the Modified Teacher's Drooling Scale (mTDS)

The primary efficacy variable was patient's response status using the change from baseline to Week 24 evaluations of the mTDS assessment. Each patient was classified as a responder or non-responder according to the change in their mean mTDS rating from baseline to Week 24. Responders were patients who had at least a 3-point decrease in mTDS rating from baseline (NCT00491894)
Timeframe: 6 months

InterventionParticipants (Number)
RespondersNon-RespondersMissing
Patients With Chronic Drooling68627

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Parent/Caregiver's Global Assessment of Treatment

The parent/caregiver performed an overall evaluation of glycopyrrolate liquid for the treatment of drooling, benefits, and side effects over the duration of the study. The parent/caregiver selected one of the following choices to assess if 'This is a worthwhile treatment': 1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, 5 = strongly disagree. A dichotomous global assessment was also performed and summarized with the categories 'responder' (strongly agree and agree responses aggregated) and 'non-responder'(neutral, disagree, and strongly disagree responses aggregated) (NCT00491894)
Timeframe: Week 24

InterventionParticipants (Number)
RespondersNon-RespondersMissing
Patients With Chronic Drooling1012016

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Investigator's Global Assessment of Treatment

The investigator performed an overall evaluation of glycopyrrolate liquid for the treatment of drooling, benefits, and side effects over the duration of the study. The investigator selected one of the following choices to assess if 'This is a worthwhile treatment': 1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, 5 = strongly disagree. A dichotomous global assessment was also performed and summarized with the categories 'responder' (strongly agree and agree responses aggregated) and 'non-responder' (neutral, disagree, and strongly disagree responses aggregated) (NCT00491894)
Timeframe: Week 24

InterventionParticipants (Number)
RespondersNon-RespondersMissing
Patients With Chronic Drooling1091810

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Parent/Caregiver's Assessment of the Extent of Drooling Using Visual Analog Scale (VAS)

"Parents/caregivers were to complete a 10 cm Parent/Caregiver's Assessment of Extent of Drooling for the Day VAS assessment (0 = normal; 10 = extremely wet) to provide an overall assessment of the extent of drooling for that day." (NCT00491894)
Timeframe: Baseline

InterventionVAS score (Mean)
Patients With Chronic Drooling6.56

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Parent/Caregiver's Assessment of the Extent of Drooling Using VAS

"Parents/caregivers were to complete a 10 cm Parent/Caregiver's Assessment of Extent of Drooling for the Day VAS assessment (0 = normal; 10 = extremely wet) to provide an overall assessment of the extent of drooling for that day." (NCT00491894)
Timeframe: Week 24

InterventionVAS score (Mean)
Patients With Chronic Drooling3.21

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Least Squares Means of FEV1 (L) at Day 1, by Timepoint

FEV1 was measured at 5, 15, 30 minutes, 1, 2, 3, 4, 5, 23 hours and 15 minutes, and 23 hours and 45 minutes post dose. (NCT00501852)
Timeframe: Day 1

,,,,,
InterventionLiters (Least Squares Mean)
Day 1: -45 minutesDay 1: -15 minutesDay 1: 5 minutesDay 1: 15 minutesDay 1: 30 minutesDay 1: 1 hourDay 1: 2 hoursDay 1: 3 hoursDay 1: 4 hoursDay 1: 5 hoursDay 1: 23 hours 15 minutesDay 1: 23 hours 45 minutesTrough
NVA237 100 ug1.241.261.351.411.451.481.521.531.521.491.371.391.38
NVA237 12.5 ug1.251.251.301.361.411.421.441.431.411.391.271.291.28
NVA237 25 ug1.241.261.341.411.441.461.481.481.451.431.291.311.30
NVA237 50 ug1.241.251.341.411.441.461.501.491.491.441.361.371.36
Placebo1.241.261.261.271.281.281.311.301.301.281.241.251.24
Tiotropium Bromide1.251.251.311.351.401.411.451.461.461.451.351.371.36

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Trough Forced Expiratory Volume in 1 Second (FEV1) Following 7 Days of Treatment

FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing. The trough in FEV1 was defined as the mean of two measurements at 23h 15min and 23h 45min post dosing. (NCT00501852)
Timeframe: Day 7

InterventionLiters (Least Squares Mean)
NVA237 12.5 ug1.317
NVA237 25 ug1.333
NVA237 50 ug1.374
NVA237 100 ug1.385
Placebo1.243
Tiotropium Bromide1.370

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Safety of Treatment With NVA237 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD)

The assessment of safety was based on adverse events, particularly those adverse events known to be associated to treatment with muscarinic antagonists. A summary of adverse events is presented with this outcome, additional details are provided in Adverse Events Sections. (NCT00510510)
Timeframe: 28 days

,,
InterventionParticipants (Number)
Total number of patients with any AETotal number with any significant AE
NVA237 100 µg263
NVA237 200 µg264
Placebo246

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Least Squares Means of Trough Forced Expiratory Volume in One Second (FEV1), by Day

Forced expiratory volume maneuvers recorded using a calibrated spirometer. Trough forced expiratory volume in one second (FEV1) on Days 1 & 28 defined as the mean of the FEV1 values measured at 23 hours 15 minutes and 23 hours 45 minutes post-dose. (NCT00510510)
Timeframe: 28 Days

,,
InterventionLiters (Least Squares Mean)
Trough FEV1 Day 1Trough FEV1 Day 28
NVA237 100 µg1.4651.502
NVA237 200 µg1.4801.492
Placebo1.3341.341

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Change From Baseline in QTc (Fridericia's Formula) at Day 7

The change from baseline in QTc at 30 minutes and 2 hours post dose on day 7. QT calculated (QTc) was calculated from the QT interval and RR (in seconds) using Fridericia's formula: QTc = QT / 3√ RR. Least square means are based on the analysis of covariance: response variable = center + treatment + baseline value + FEV1 before inhalation of salbutamol/albuterol + FEV1 30 min post inhalation of salbutamol/albuterol. (NCT00558285)
Timeframe: Baseline, Day 7

,,,,
Interventionmilliseconds (Least Squares Mean)
30 minutes2 hours
Indacaterol 300 μg-1.3-1.6
Indacaterol/Glycopyrrolate 150/100 μg0.51.6
Indacaterol/Glycopyrrolate 300/100 μg-0.9-1.2
Indacaterol/Glycopyrrolate 600/100 μg4.12.6
Placebo-2.2-2.8

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Change From Baseline in QTc (Fridericia's Formula) at Day 14

The change from baseline in QTc at 30 minutes, 4 hours and 23 hours 45 minutes post dose on day 14. QT calculated (QTc) was calculated from the QT interval and RR (in seconds) using Fridericia's formula: QTc = QT / 3√ RR. Least square means are based on the analysis of covariance: response variable = center + treatment + baseline value + FEV1 before inhalation of salbutamol/albuterol + FEV1 30 minutes post inhalation of salbutamol/albuterol. (NCT00558285)
Timeframe: Baseline, Day 14

,,,,
Interventionmilliseconds (Least Squares Mean)
30 minutes4 hours23 hours 45 minutes
Indacaterol 300 μg-1.2-2.6-3.6
Indacaterol/Glycopyrrolate 150/100 μg1.63.10.4
Indacaterol/Glycopyrrolate 300/100 μg-0.6-0.1-2.9
Indacaterol/Glycopyrrolate 600/100 μg2.42.80.5
Placebo0.2-0.1-1.6

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Change From Baseline in QTc (Fridericia's Formula) at Day 1

The change from baseline in QTc at 30 minutes, 4 hours and 23 hours 45 minutes post dose on day 1. QT calculated (QTc) was calculated from the QT interval and RR (in seconds) using Fridericia's formula: QTc = QT / 3√ RR. Least square means are based on the analysis of covariance: response variable = center + treatment + baseline value + FEV1 before inhalation of salbutamol/albuterol + FEV1 30 min post inhalation of salbutamol/albuterol. (NCT00558285)
Timeframe: Baseline, Day 1

,,,,
Interventionmilliseconds (Least Squares Mean)
30 minutes4 hours23 hours 45 minutes
Indacaterol 300 μg3.11.1-2.1
Indacaterol/Glycopyrrolate 150/100 μg1.42.4-0.1
Indacaterol/Glycopyrrolate 300/100 μg1.20.5-1.7
Indacaterol/Glycopyrrolate 600/100 μg1.62.82.7
Placebo-1.6-2.3-2.3

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Change From Baseline in Mean 24 Hour Heart Rate at Day 14

Heart rate was assessed by Holter monitoring and was measured over a 24 hour period at day 14. Heart rate was defined as the average value over the 24 hour monitoring period. The baseline measurement was the average heart rate taken from the 24 hour Holter monitoring period performed at screening or the last 24-hour period before taking the first dose of study drug. Least square means are based on the analysis of covariance: 24 hours mean heart rate = center + treatment + baseline value + Forced Expiratory Volume in one second (FEV1) before inhalation of salbutamol/albuterol + FEV1 30 min post salbutamol/albuterol + error. (NCT00558285)
Timeframe: Baseline, Day 14

Interventionbeats per minute (Least Squares Mean)
Indacaterol/Glycopyrrolate 600/100 μg-0.113
Indacaterol/Glycopyrrolate 300/100 μg0.787
Indacaterol/Glycopyrrolate 150/100 μg-0.230
Indacaterol 300 μg0.240
Placebo0.170

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Change From Baseline in Mean 24 Hour Heart Rate at Day 1

Heart rate was assessed by Holter monitoring and was measured over a 24 hour period at day 1. Heart rate was defined as the average value over the 24 hour monitoring period. The baseline measurement was the average heart rate taken from the 24 hour Holter monitoring period performed at screening or the last 24-hour period before taking the first dose of study drug. Least squares means are based on the analysis of covariance: 24 hours mean heart rate = center + treatment + baseline value + Forced Expiratory Volume in one second (FEV1) before inhalation of salbutamol/albuterol + FEV1 30 min after inhalation of salbutamol/albuterol + error. (NCT00558285)
Timeframe: Baseline, Day 1

Interventionbeats per minute (Least Squares Mean)
Indacaterol/Glycopyrrolate 600/100 μg-2.877
Indacaterol/Glycopyrrolate 300/100 μg-2.770
Indacaterol/Glycopyrrolate 150/100 μg-0.547
Indacaterol 300 μg-1.849
Placebo-0.329

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Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Day 14

Spirometry testing was performed in accordance with American Thoracic Society standards. Trough FEV1 was defined as the mean of two measurements at 23 hours 15 minutes and 23 hour 45 minutes post dosing. Baseline is defined as the mean of the two values taken at 45 minutes and 15 minutes prior to dosing at day 1. Least square means are based on the analysis of covariance: response variable=center + treatment + baseline value + Forced Expiratory Volume in one second (FEV1) before inhalation of salbutamol/albuterol + FEV1 30 minutes post inhalation of salbutamol/albuterol. (NCT00558285)
Timeframe: Day 1, Day 14

,,,,
InterventionLiters (Least Squares Mean)
Day 1Day 14
Indacaterol 300 μg1.441.46
Indacaterol/Glycopyrrolate 150/100 μg1.501.50
Indacaterol/Glycopyrrolate 300/100 μg1.511.52
Indacaterol/Glycopyrrolate 600/100 μg1.591.61
Placebo1.271.31

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Trough Forced Vital Capacity (FVC) at Day 1 and Day 14

Spirometry testing was performed in accordance with American Thoracic Society standards. Trough FVC was defined as the mean of two measurements at 23 hours 15 minutes and the 23 hours 45 minutes post dosing. Baseline was defined as the mean of the two values taken at 45 minutes and 15 minutes prior to dosing at day 1. Analysis of covariance: FVC parameter = center + treatment + baseline FVC + FEV1 before inhalation of salbutamol/albuterol + FEV1 30 min after inhalation of salbutamol/albuterol + error. (NCT00558285)
Timeframe: Day 1 and Day 14

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InterventionLiters (Least Squares Mean)
Day 1Day 14 (n=42, 45, 44, 48, 47)
Indacaterol 300 μg2.9242.901
Indacaterol/Glycopyrrolate 150/100 μg3.0002.952
Indacaterol/Glycopyrrolate 300/100 μg3.0293.042
Indacaterol/Glycopyrrolate 600/100 μg3.1513.134
Placebo2.6342.726

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Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 7

Spirometry testing was performed in accordance with American Thoracic Society standards. Trough FEV1 was defined as the average of the 23 hour 15 minute and 23 hour 45 minute measurements post dosing. Baseline FEV1 is the mean of the 45 minute and 15 minute pre-dose FEV1 values at day 1 of each period. Least square means are based on the Analysis of Covariance Trough FEV1 at day 7 = sequence effect + patient(sequence) + period effect + treatment effect + (period) baseline FEV1 + error. (NCT00570778)
Timeframe: Baseline, Day 7

InterventionLiters (Least Squares Mean)
Indacaterol/Glycopyrrolate 300/50 μg1.512
Indacaterol 300 μg1.389
Indacaterol 600 μg1.395
Placebo1.286

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Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under Curve (AUC) 5 Minutes-12 Hours at Day 7

Spirometry testing was performed in accordance with American Thoracic Society standards. FEV1 was assessed at 5, 15, 30 minutes, 1, 2, 3, 4, 5, 6, 8, 10 and 12 hours post dose on Day 7. Standardized (with respect to time) AUC (5 minutes-12 hours) for FEV1 on day 7 was calculated using the trapezoidal rule. Least square means are based on the Analysis of Covariance: FEV1 AUC = sequence effect + patient (sequence) + period + treatment + baseline FEV1 (period) + error. (NCT00570778)
Timeframe: Day 7

InterventionLiters (Least Squares Mean)
Indacaterol/Glycopyrrolate 300/50 μg1.610
Indacaterol 300 μg1.473
Indacaterol 600 μg1.457
Placebo1.317

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Number of Participants With Adverse Events, Serious Adverse Events and Discontinuations Due to Adverse Events

Additional information about adverse events can be found in the Adverse Event Section. (NCT00570778)
Timeframe: 47 days

,,,
InterventionParticipants (Number)
Serious Adverse EventsAdverse EventsDiscontinuations Due to Adverse Events
Indacaterol 300 μg0310
Indacaterol 600 μg0372
Indacaterol/Glycopyrrolate 300/50 μg2393
Placebo0310

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Forced Expiratory Volume in One Second (FEV1) Area Under Curve (AUC) 0-24 Hours on Day 14

Forced Expiratory Volume in one second (FEV1) was calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. This outcome measures the change is FEV1 from predose (day 1) to the readings taken 0-24 hours post dose on day 14. The variable was analyzed with an analysis-of-covariance model which included baseline FEV1 value as a covariate. (NCT00856193)
Timeframe: From Day 1 to 0-24 hours after drug administration on Day 14

InterventionLiters (Least Squares Mean)
NVA237 50μg1.827
Placebo1.664

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Forced Expiratory Volume in One Second (FEV1) AUC 0-12 Hours on Day 14

Forced Expiratory Volume in one second (FEV1) was calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. This outcome measures the change is FEV1 from pre-dose (day 1) to the readings taken 0-12 hours post dose on day 14. The variable was analyzed with an analysis-of-covariance model which included baseline FEV1 value as a covariate. (NCT00856193)
Timeframe: From day 1 to 0 -12 hours after drug administration on Day 14

InterventionLiters (Least Squares Mean)
NVA237 50μg1.879
Placebo1.714

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Forced Expiratory Volume in One Second (FEV1) AUC 12-24 Hours on Day 14

Forced Expiratory Volume in one second (FEV1) was calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. This outcome measures the change is FEV1 from pre-dose (day 1) to the readings taken 12-24 hours post dose on day 14. The variable was analyzed with an analysis-of-covariance model which included baseline FEV1 value as a covariate. (NCT00856193)
Timeframe: From Day 1 to 12 hours-24 hours after drug administration on Day 14

InterventionLiters (Least Squares Mean)
NVA237 50μg1.776
Placebo1.615

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Number of Participants Who Experienced Adverse Events (AEs), Serious Adverse Events (SAEs)

According to FDA 21CFR 314.80, a serious adverse event (SAE) is described as any adverse event that leads to death, is life threatening , causes or prolongs hospitalization, results in a congenital anomaly, or any other important medical event not described above. See Adverse Events module for details. (NCT00856193)
Timeframe: Day 14

,
InterventionParticipants (Number)
Overall Adverse EventsSerious Adverse Events (SAEs)
NVA237 50μg20
Placebo40

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Forced Vital Capacity (FVC) 5, 15, and 30 Minutes; and 1, 2, 3, and 4 Hours Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

"Just prior to FVC measurement, patients performed normal tidal breathing. The patient was given a few breaths warning before being told At the end of the next normal breath out, take a deep breath all the way in; they were then verbally encouraged to make a maximal effort before relaxing. The analysis included the same covariates as the primary Outcome Measure. Data was not collected at all time points for all Days and Weeks." (NCT00929110)
Timeframe: 5, 15, and 30 minutes; and 1, 2, 3, 4 hours post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

,,
InterventionLiters (Least Squares Mean)
Day 1, minute 5 (n=495, 255, 253)Day 1, minute 15 (n=502, 255, 254)Day 1, minute 30 (n=507, 252, 254)Day 1, hour 1 (n=511, 256, 254)Day 1, hour 2 (n=513, 253, 252)Day 1, hour 3 (n=510, 248, 252)Day 1, hour 4 (n=504, 239, 250)Day 1, hour 23, minute 15 (n=481, 243, 239)Day 1, hour 23, minute 45 (n=474, 239, 232)Day 15, minute 5 (n=498, 223, 243)Day 15, minute 15 (n=487, 229, 239)Day 15, minute 30 (n=503, 233, 242)Day 15, hour 1 (n=501, 229, 240)Week 5, minute 5 (n=476, 221, 231)Week 5, minute 15 (n=479, 222, 234)Week 5, minute 30 (n=480, 223, 234)Week 9, minute 5 (n=454, 217, 227)Week 9, minute 15 (n=459, 220, 225)Week 9, minute 30 (n=460, 220, 226)Week 12, minute 5 (n=453, 212, 230)Week 12, minute 15 (n=448, 205, 222)Week 12, minute 30 (n=455, 212, 226)Week 12, hour 1 (n=455, 210, 227)Week 12, hour 2 (n=446, 207, 225)Week 12, hour 3 (n=444, 204, 225)Week 12, hour 4 (n=437, 202, 224)Week 12, hour 23, minute 15 (n=430, 200, 214)Week 12, hour 23, minute 45 (n=426, 195, 205)Week 16, minute 5 (n=429, 207, 218)Week 16, minute 15 (n=428, 209, 219)Week 16, minute 30 (n=433, 209, 220)Week 20, minute 5 (n=430, 206, 218)Week 20, minute 15 (n=430, 207, 220)Week 20, minute 30 (n=431, 207, 221)Week 26, minute 5 (421, 202, 213)Week 26, minute 15 (n=414, 200, 207)Week 26, minute 30 (n=424, 206, 213)Week 26, hour 1 (n=425, 206, 212)Week 26, hour 2 (n=420, 203, 208)Week 26, hour 3 (n=416, 204, 213)Week 26, hour 4 (n=416, 203, 208)Week 26, hour 23, minute 15 (n=405, 187, 202)Week 26, hour 23, minute 45 (n=401, 185, 198)Week 34, minute 5 (n=408, 194, 212)Week 34, minute 15 (n=407, 191, 214)Week 34, minute 30 (n=410, 196, 215)Week 34, hour 1 (n=412, 195, 215)Week 42, minute 5 (n=398, 189, 199)Week 42, minute 15 (n=405, 188, 201)Week 42, minute 30 (n=405, 189, 201)Week 50, minute 5 (n=386, 185, 199)Week 50, minute 15 (n=391, 187, 203)Week 50, minute 30 (n=392, 186, 204)Week 52, minute 5 (n=401, 188, 197)Week 52, minute 15 (n=394, 183, 200)Week 52, minute 30 (n=402, 189, 202)Week 52, hour 1 (n=404, 190, 201)Week 52, hour 2 (n=402, 186, 202)Week 52, hour 3 (n=400, 186, 199)Week 52, hour 4 (n=397, 184, 199)Week 52, hour 23, minute 15 (n=388, 183, 198)Week 52, hour 23, minute 45 (n=395, 185, 199)
Glycopyrronium Bromide 50 μg2.9152.9823.0043.0743.1193.1293.0762.9262.9302.9843.0163.0283.0683.0043.0243.0853.0473.0503.0792.9913.0032.9853.0623.0933.1293.0502.9912.9773.0163.0293.0632.9853.0203.0582.9562.9802.9833.0343.0493.0973.0222.9712.9522.9672.9833.0023.0142.9823.0013.0162.9252.9712.9992.8992.9422.9232.9922.9973.0292.9842.8662.869
Placebo to Glycopyrronium Bromide2.7312.7192.6922.7322.7622.8112.7672.7452.7492.7602.7482.7562.7572.7682.7712.8042.7672.7642.7682.7262.7352.7072.7412.8012.8392.7932.7992.7992.7532.7372.7472.7442.7492.7742.7332.7132.7152.7212.7772.8312.7762.7582.7592.7132.7182.6902.7112.7272.7132.7342.7292.7292.7312.6732.7012.6662.6962.7272.7422.7252.6752.694
Tiotropium 18 μg2.8562.9032.9372.9753.0333.0733.0312.9232.9232.9803.0303.0183.0233.0113.0243.0633.0293.0463.0792.9783.0042.9873.0483.0653.0963.0542.9852.9463.0093.0023.0362.9662.9943.0282.9452.9592.9492.9973.0363.0653.0212.9012.8832.9192.9482.9472.9592.9833.0013.0212.9422.9622.9982.9162.9692.9623.0113.0053.0202.9912.8652.868

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Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1, Week 26, and Week 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. Trough FEV1 was defined as the average of measurements made 23 hours 15 minutes and 23 hours 45 minutes post-dose. The analysis included the same covariates as the primary Outcome Measure. (NCT00929110)
Timeframe: Day 1, Week 26, and Week 52

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InterventionLiters (Least Squares Mean)
Day 1Week 26 (n=451, 219, 233)Week 52 (n=416, 196, 210)
Glycopyrronium Bromide 50 μg1.4781.4581.412
Placebo to Glycopyrronium Bromide1.3881.3241.303
Tiotropium 18 μg1.4711.4081.392

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Trough Forced Vital Capacity (FVC) at Day 1, Week 12, Week 26, and Week 52

"Trough FVC is defined as the average of the post-dose 23 h 15 min and the 23 h 45 min FVC values. Just prior to FVC measurement, patients performed normal tidal breathing. The patient was given a few breaths warning before being told At the end of the next normal breath out, take a deep breath all the way in; they were then verbally encouraged to make a maximal effort before relaxing. The analysis included the same covariates as the primary Outcome Measure." (NCT00929110)
Timeframe: Day 1, Week 12, Week 26, and Week 52

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InterventionLiters (Least Squares Mean)
Day 1Week 12 (n=442, 204, 217)Week 26 (n=418, 196, 208)Week 52 (n=395, 186, 201)
Glycopyrronium Bromide 50 μg2.9362.9852.9622.866
Placebo to Glycopyrronium Bromide2.7572.8022.7582.687
Tiotropium 18 μg2.9302.9702.8922.866

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Number of Moderate or Severe Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) Per Year During the Study (Baseline to Week 52)

The number of moderate or severe exacerbations of COPD per year during the study was calculated by dividing the total number of exacerbations during the study by the total number of years of treatment. A COPD exacerbation was considered to be moderate if treatment with systemic corticosteroids and/or antibiotic was required. A COPD exacerbation was considered to be severe if treatment for moderate severity and hospitalization was required. (NCT00929110)
Timeframe: Baseline to Week 52

InterventionExacerbations per treatment year (Number)
Glycopyrronium Bromide 50 μg0.54
Placebo to Glycopyrronium Bromide0.80
Tiotropium 18 μg0.62

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"Percentage of Days Able to Perform Usual Daily Activities During the Study (Baseline to Week 52)"

"A day able to perform usual daily activities was defined as any day where the patient recorded in their electronic diary in the evening that they were not prevented from performing their usual daily activities due to respiratory symptoms during the previous 12 hours. The percentage of days able to perform usual daily activities was calculated as the total number of days able to perform usual daily activities over the 52 week treatment period divided by the total number of days where diary recordings were made." (NCT00929110)
Timeframe: Baseline to Week 52

InterventionPercentage of days (Least Squares Mean)
Glycopyrronium Bromide 50 μg38.02
Placebo to Glycopyrronium Bromide36.18
Tiotropium 18 μg38.09

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"Percentage of Days With no Daytime Symptoms During the Study (Baseline to Week 52)"

"A day with no daytime symptoms was defined as any day where the patient recorded no cough, no wheeze, no production of sputum, no feeling of breathlessness (other than when running), and no puffs of rescue medication during the previous 12 hours in evening entry in the electronic patient diary. The percentage of days with no daytime symptoms was calculated as the total number of days with no daytime symptoms over the 52 week treatment period divided by the total number of days where diary recordings were made." (NCT00929110)
Timeframe: Baseline to Week 52

InterventionPercentage of days (Least Squares Mean)
Glycopyrronium Bromide 50 μg6.54
Placebo to Glycopyrronium Bromide3.81
Tiotropium 18 μg7.14

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"Percentage of Nights With no Nighttime Awakenings During the Study (Baseline to Week 52)"

"A night with no nighttime awakenings was defined as any night where the patient did not wake up due to 1 or more of 6 symptoms (respiratory symptoms, cough, wheeze, amount of sputum, color of sputum, and breathlessness). Symptoms occurring during the previous 12 hours were recorded each morning and evening by the patient in an electronic diary. The percentage of nights with 'no nighttime awakenings' was calculated as the total number of nights with no nighttime awakenings over the 52 week treatment period divided by the total number of nights where diary recordings were made." (NCT00929110)
Timeframe: Baseline to Week 52

InterventionPercentage of nights (Least Squares Mean)
Glycopyrronium Bromide 50 μg57.36
Placebo to Glycopyrronium Bromide52.15
Tiotropium 18 μg55.47

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Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Taken During the Study (Baseline to Week 52)

The number of puffs of rescue medication taken in the previous 12 hours was recorded in the Patient Diary in the morning and evening. The mean daily number of puffs of rescue medication taken was calculated by dividing the number of puffs of rescue medication per day over the 52 weeks of the study by the number of days with non-missing rescue medication data. Rescue medication data recorded during the 14 day run-in period was used to calculate the baseline. The analysis included the same covariates as the primary Outcome Measure. A positive change score indicates more puffs taken. (NCT00929110)
Timeframe: Baseline to Week 52

InterventionPuffs (Least Squares Mean)
Glycopyrronium Bromide 50 μg-1.58
Placebo to Glycopyrronium Bromide-1.20
Tiotropium 18 μg-1.83

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Change From Baseline in the Mean Daily Total Symptom Score During the Study (Baseline to Week 52)

The daily total symptom score was defined as the sum of the morning and evening patient self-reported diary assessments of 6 symptoms (respiratory symptoms/impact on daily activities, cough, wheeze, amount of sputum, color of sputum, and breathlessness). Means for baseline (14 day maximum run-in period) and the 52 week treatment period were calculated. Mean scores ranged from 0-18, with a higher score indicating worse symptoms. A negative change score indicated improvement. (NCT00929110)
Timeframe: Baseline to Week 52

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium Bromide 50 μg-1.85
Placebo to Glycopyrronium Bromide-1.42
Tiotropium 18 μg-1.87

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Percentage of Patients Who Experienced a Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During the Study (Baseline to Week 52)

A COPD exacerbation was considered to be moderate if treatment with systemic corticosteroids and/or antibiotic was required. A COPD exacerbation was considered to be severe if treatment for moderate severity and hospitalization was required. (NCT00929110)
Timeframe: Baseline to Week 52

InterventionPercentage of participants (Number)
Glycopyrronium Bromide 50 μg32.8
Placebo to Glycopyrronium Bromide40.2
Tiotropium 18 μg30.1

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Time to First Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During the Study (Baseline to Week 52)

Time to first moderate or severe COPD exacerbation was calculated as the number of days from baseline to the day on which the patient experienced the first moderate or severe COPD exacerbation. A COPD exacerbation was considered to be moderate if treatment with systemic corticosteroids and/or antibiotic was required. A COPD exacerbation was considered to be severe if treatment for moderate severity and hospitalization was required. (NCT00929110)
Timeframe: Baseline to Week 52 (patients with no moderate or severe exacerbations who completed the study were censored at the final visit date, which may have exceeded 52 weeks)

InterventionDays (Median)
Glycopyrronium Bromide 50 μg363.0
Placebo to Glycopyrronium Bromide231.0
Tiotropium 18 μg364.0

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Transition Dyspnea Index (TDI) at Week 26

The TDI measured changes in dyspnea from baseline during treatment and included 3 domains: Functional impairment (activities of daily living), magnitude of task (intensity of activity), and magnitude of effort (difficulty breathing). Each domain was rated from -3 to 3 (major deterioration-major improvement). The total score ranged from -9 to 9; minus scores indicate deterioration. The analysis included the same covariates as the primary Outcome Measure. (NCT00929110)
Timeframe: Week 26

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium Bromide 50 μg2.13
Placebo to Glycopyrronium Bromide1.32
Tiotropium 18 μg2.26

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Trough Forced Expiratory Volume in 1 Second (FEV1) at Week 12

FEV1 was measured with spirometry conducted according to internationally accepted standards. Trough FEV1 was defined as the average of measurements made 23 hours 15 minutes and 23 hours 45 minutes post-dose. The analysis included baseline FEV1 measurement, baseline inhaled corticosteroid use (Yes/No), FEV1 prior to inhalation of short-acting β2 agonist (SABA), and FEV1 45 min post-inhalation of SABA as covariates. (NCT00929110)
Timeframe: Week 12

InterventionLiters (Least Squares Mean)
Glycopyrronium Bromide 50 μg1.469
Placebo to Glycopyrronium Bromide1.372
Tiotropium 18 μg1.455

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Forced Expiratory Volume in 1 Second (FEV1) 5, 15, and 30 Minutes; 1, 2, 3, 4, 6, 8, 10, and 12 Hours; 23 Hours 15 Minutes; and 23 Hours 45 Minutes Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. The analysis included the same covariates as the primary Outcome Measure. Data was not collected at all time points for all Days and Weeks. (NCT00929110)
Timeframe: 5, 15, and 30 minutes; 1, 2, 3, 4, 6, 8, 10, and 12 hours; 23 hours 15 minutes; and 23 hours 45 minutes post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

,,
InterventionLiters (Least Squares Mean)
Day 1, minute 5 (n=135, 74, 74)Day 1, minute 15 (n=139, 75, 74)Day 1, minute 30 (n=143, 77, 74)Day 1, hour 1 (n=144, 76, 75)Day 1, hour 2 (n=144, 75, 75)Day 1, hour 3 (n=143, 74, 73)Day 1, hour 4 (n=144, 70, 74)Day 1, hour 6 (n=142, 71, 74)Day 1, hour 8 (n=137, 70, 75)Day1, hour 10 (n=134, 72, 75)Day 1, hour 12 (n=130, 69, 70)Day 1, hour 23, minute 15 (n=129, 71, 72)Day 1, hour 23, minute 45 (n=128, 74, 75)Day 15, minute 5 (n=135, 65, 73)Day 15, minute 15 (n=133, 70, 72)Day 15, minute 30 (n= 139, 70, 74)Day 15, hour 1 (n=140, 68, 74)Week 5, minute 5 (n=134, 66, 68)Week 5, minute 15 (n=136, 67, 70)Week 5, minute 30 (n=135, 67, 70)Week 9, minute 5 (n=128, 66, 70)Week 9, minute 15 (n=130, 66, 71)Week 9, minute 30 (n=130, 67, 71)Week 12, minute 5 (n=130, 69, 70)Week 12, minute 15 (n=129, 67, 66)Week 12, minute 30 (n=133, 69, 67)Week 12, hour 1 (n=132, 67, 69)Week 12, hour 2 (n=129, 65, 68)Week 12, hour 3 (n=126, 64, 69)Week 12, hour 4 (n=124, 64, 68)Week 12, hour 6 (n=123, 63, 69)Week 12, hour 8 (n=121, 64, 69)Week 12, hour 10 (n=124, 61, 69)Week 12, hour 12 (n=122, 58, 68)Week 12, hour 16 (n=109, 56, 57)Week 12, hour 22 (n=117, 60, 63)Week 12, hour 23, minute 15 (n=126, 66, 67)Week 12, hour 23, minute 45 (n=124, 65, 63)Week 16, minute 5 (n=123, 65, 64)Week 16, minute 15 (n=124, 65, 65)Week 16, minute 30 (n=125, 65, 65)Week 20, minute 5 (n=125, 66, 63)Week 20, minute 15 (n=124, 65, 63)Week 20, minute 30 (n=125, 65, 63)Week 26, minute 5 (n=123, 62, 64)Week 26, minute 15 (n=121, 61, 61)Week 26, minute 30 (n=125, 64, 64)Week 26, hour 1 (n=127, 64, 64)Week 26, hour 2 (n=124, 64, 63)Week 26, hour 3 (n=124, 64, 64)Week 26, hour 4 (n=124, 64, 62)Week 26, hour 23, minute 15 (n=120, 55, 61)Week 26, hour 23, minute 45 (n=117, 56, 61)Week 34, minute 5 (n=125, 62, 63)Week 34, minute 15 (n=123, 62, 63)Week 34, minute 30 (n=125, 62, 62)Week 34, hour 1 (n=125, 62, 63)Week 42, minute 5 (n=119, 61, 58)Week 42, minute 15 (n=123, 61, 58)Week 42, minute 30 (n=123, 61, 58)Week 50, minute 5 (n=120, 60, 57)Week 50, minute 15 (n=123, 60, 57)Week 50, minute 30 (n=123, 60, 58)Week 52, minute 5 (n=124, 60, 57)Week 52, minute 15 (n=122, 59, 58)Week 52, minute 30 (n=125, 62, 58)Week 52, hour 1 (n=125, 62, 57)Week 52, hour 2 (n=124, 61, 58)Week 52, hour 3 (n=123, 62, 56)Week 52, hour 4 (n=121, 60, 55)Week 52, hour 6 (n=118, 59, 54)Week 52, hour 8 (n=119, 59, 54)Week 52, hour 10 (n=119, 59, 55)Week 52, hour 12 (n=120, 58, 52)Week 52, hour 16 (n=117, 53, 46)Week 52, hour 22 (n=118, 60, 52)Week 52, hour 23, 15 minutes (n=121, 62, 57)Week 52, hour 23, 45 minutes (n=122, 61, 57)
Glycopyrronium Bromide 50 μg1.4941.5481.5611.5831.6391.6291.5991.5781.5441.5461.5221.4711.5181.4941.5301.5511.5751.5501.5751.6301.5621.5831.6031.4971.5231.5171.5571.5961.6001.5841.5581.5351.5411.5221.4311.4201.5181.5131.5381.5571.5701.5181.5351.5761.4831.5211.5291.5461.5901.6141.5771.4771.4831.5151.5291.5671.5571.5121.5201.5371.4901.5291.5451.4561.5021.4831.5251.5541.5581.5351.4941.4731.4781.4511.3771.3911.4471.434
Placebo to Glycopyrronium Bromide1.4161.4281.4091.4041.4451.4351.4151.4261.4311.4151.3691.3961.4461.4211.4111.4171.4091.4481.4521.4811.4171.4411.4271.3851.3731.3621.3691.4341.4431.4421.4431.4081.4351.4221.3601.3491.4561.4701.4301.4221.4091.3931.3801.3911.3611.3771.3531.3641.4221.4421.4161.3741.4011.3591.3601.3531.3521.3941.4121.3911.3571.3751.3681.3371.3801.3661.3561.4181.3841.3811.3701.3581.3491.3691.2771.3141.3621.337
Tiotropium 18 μg1.4471.4851.4831.5141.5691.5871.5601.5751.5451.5371.4801.4811.4991.4901.5371.5161.5401.5251.5431.5841.5201.5341.5491.4741.4811.4881.5191.5651.5661.5351.5201.4791.5321.4871.3781.3711.5201.4881.5151.5301.5351.4531.4791.5021.4151.4641.4391.4621.5201.5551.5191.4161.4051.4071.4251.4521.4721.4901.4911.5171.4221.4521.4701.3771.4281.4071.4391.4791.4871.4681.4611.4181.4191.3471.3291.2821.3871.359

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Forced Expiratory Volume in 1 Second (FEV1) 5, 15, and 30 Minutes; and 1, 2, 3, and 4 Hours Post Dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. The analysis included the same covariates as the primary Outcome Measure. Data was not collected at all time points for all Days and Weeks. (NCT00929110)
Timeframe: 5, 15, and 30 minutes; and 1, 2, 3, 4 hours post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

,,
InterventionLiters (Least Squares Mean)
Day 1, minute 5 (n=495, 255, 253)Day 1, minute 15 (n=502, 255, 254)Day 1, minute 30 (n=507, 252, 254)Day 1, hour 1 (n=511, 256, 254)Day 1, hour 2 (n=513, 253, 252)Day 1, hour 3 (n=510, 248, 252)Day 1, hour 4 (n=504, 239, 250)Day 1, hour 23, minute 15 (n=481, 243, 239)Day 1, hour 23, minute 45 (n=474, 239, 232)Day 15, minute 5 (n=498, 223, 243)Day 15, minute 15 (n=487, 229, 239)Day 15, minute 30 (n=503, 233, 242)Day 15, hour 1 (n=501, 229, 240)Week 5, minute 5 (n=476, 221, 231)Week 5, minute 15 (n=479, 222, 234)Week 5, minute 30 (n=480, 223, 234)Week 9, minute 5 (n=454, 217, 227)Week 9, minute 15 (n=459, 220, 225)Week 9, minute 30 (n=460, 220, 226)Week 12, minute 5 (n=453, 212, 230)Week 12, minute 15 (n=448, 205, 222)Week 12, minute 30 (n=455, 212, 226)Week 12, hour 1 (n=455, 210, 227)Week 12, hour 2 (n=446, 207, 225)Week 12, hour 3 (n=444, 204, 225)Week 12, hour 4 (n=437, 202, 224)Week 12, hour 23, minute 15 (n=430, 200, 214)Week 12, hour 23, minute 45 (n=426, 195, 205)Week 16, minute 5 (n=429, 207, 218)Week 16, minute 15 (n=428, 209, 219)Week 16, minute 30 (n=433, 209, 220)Week 20, minute 5 (n=430, 206, 218)Week 20, minute 15 (n=430, 207, 220)Week 20, minute 30 (n=431, 207, 221)Week 26, minute 5 (421, 202, 213)Week 26, minute 15 (n=414, 200, 207)Week 26, minute 30 (n=424, 206, 213)Week 26, hour 1 (n=425, 206, 212)Week 26, hour 2 (n=420, 203, 208)Week 26, hour 3 (n=416, 204, 213)Week 26, hour 4 (n=416, 203, 208)Week 26, hour 23, minute 15 (n=405, 187, 202)Week 26, hour 23, minute 45 (n=401, 185, 198)Week 34, minute 5 (n=408, 194, 212)Week 34, minute 15 (n=407, 191, 214)Week 34, minute 30 (n=410, 196, 215)Week 34, hour 1 (n=412, 195, 215)Week 42, minute 5 (n=398, 189, 199)Week 42, minute 15 (n=405, 188, 201)Week 42, minute 30 (n=405, 189, 201)Week 50, minute 5 (n=386, 185, 199)Week 50, minute 15 (n=391, 187, 203)Week 50, minute 30 (n=392, 186, 204)Week 52, minute 5 (n=401, 188, 197)Week 52, minute 15 (n=394, 183, 200)Week 52, minute 30 (n=402, 189, 202)Week 52, hour 1 (n=404, 190, 201)Week 52, hour 2 (n=402, 186, 202)Week 52, hour 3 (n=400, 186, 199)Week 52, hour 4 (n=397, 184, 199)Week 52, hour 23, minute 15 (n=388, 183, 198)Week 52, hour 23, minute 45 (n=395, 185, 199)
Glycopyrronium Bromide 50 μg1.4431.5011.5241.5521.6121.5901.5901.4591.4821.4911.5271.5381.5611.5091.5381.5641.5291.5501.5691.5021.5271.5221.5561.5951.5921.5581.4811.4931.5141.5301.5461.4951.5251.5441.4791.5041.5131.5411.5701.5701.5471.4641.4741.4811.5081.5181.5341.4891.5111.5181.4541.4961.5041.4361.4711.4711.4991.5261.5251.5041.4191.424
Placebo to Glycopyrronium Bromide1.3571.3591.3571.3531.3971.3891.3961.3641.3901.3681.3711.3681.3791.3711.3891.3961.3661.3761.3781.3491.3521.3521.3641.4231.4141.4161.3811.4131.3731.3721.3721.3511.3621.3621.3391.3401.3411.3451.3881.3981.3841.3261.3541.3381.3331.3311.3311.3421.3441.3501.3361.3411.3411.3051.3231.3191.3251.3631.3441.3461.3031.320
Tiotropium 18 μg1.4021.4371.4681.4841.5491.5601.5491.4571.4731.4721.5141.5041.5251.4881.5081.5251.4991.5151.5311.4771.5011.4911.5281.5581.5611.5341.4571.4721.4871.4911.5051.4641.4951.4981.4291.4581.4511.4871.5241.5261.5041.4151.4261.4221.4431.4441.4641.4591.4771.4961.4291.4621.4751.4191.4511.4511.4821.5111.5091.5011.3971.411

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Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 12 Hours Post-dose at Day 1 and Weeks 12 and 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; and 1, 2, 3, 4, 6, 8 10, and 12 hours post-dose. Standardized FEV1 AUC was calculated by the trapezoidal rule. The analysis included the same covariates as the primary Outcome Measure. (NCT00929110)
Timeframe: From 5 minutes to 12 hours post-dose at Day 1 and Weeks 12 and 52

,,
InterventionLiters (Least Squares Mean)
Day 1Week 12 (n=133, 69, 70)Week 52 (n=125, 62, 58)
Glycopyrronium Bromide 50 μg1.5661.5391.492
Placebo to Glycopyrronium Bromide1.4071.3981.364
Tiotropium 18 μg1.5341.5051.424

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Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 23 Hours 45 Minutes and From 12 Hours to 23 Hours 45 Minutes Post-dose at Weeks 12 and 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; 1, 2, 3, 4, 6, 8, 10, and 12 hours; 23 hours 15 minutes; and 23 hours 45 minutes post-dose. Standardized FEV1 AUC was calculated by the trapezoidal rule. The analysis included the same covariates as the primary Outcome Measure. (NCT00929110)
Timeframe: From 5 minutes to 23 hours 45 minutes post-dose at Weeks 12 and 52

,,
InterventionLiters (Least Squares Mean)
Week 12Week 52 (n=125, 62, 58)
Glycopyrronium Bromide 50 μg1.4861.445
Placebo to Glycopyrronium Bromide1.3801.339
Tiotropium 18 μg1.4591.379

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Forced Expiratory Volume in 1 Second (FEV1) Standardized (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 4 Hours Post-dose at Day 1 and Weeks 12, 26, and 52

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; and 1, 2, 3, and 4 hours post-dose. Standardized FEV1 AUC was calculated by the trapezoidal rule. The analysis included the same covariates as the primary Outcome Measure. (NCT00929110)
Timeframe: From 5 minutes to 4 hours post-dose at Day 1 and Weeks 12, 26, and 52

,,
InterventionLiters (Least Squares Mean)
Day 1Week 12 (n=460, 214, 232)Week 26 (n=430, 206, 216)Week 52 (n=405, 192, 203)
Glycopyrronium Bromide 50 μg1.5701.5601.5461.502
Placebo to Glycopyrronium Bromide1.3731.3841.3691.336
Tiotropium 18 μg1.5141.5311.4951.487

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Forced Vital Capacity (FVC) 5, 15, and 30 Minutes; 1, 2, 3, 4, 6, 8, 10, and 12 Hours; 23 Hours 15 Minutes; and 23 Hours 45 Minutes Post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

"Just prior to FVC measurement, patients performed normal tidal breathing. The patient was given a few breaths warning before being told At the end of the next normal breath out, take a deep breath all the way in; they were then verbally encouraged to make a maximal effort before relaxing. The analysis included the same covariates as the primary Outcome Measure. Data was not collected at all time points for all Days and Weeks." (NCT00929110)
Timeframe: 5, 15, and 30 minutes; 1, 2, 3, 4, 6, 8, 10, and 12 hours; 23 hours 15 minutes; and 23 hours 45 minutes post-dose at Days 1 and 15; and Weeks 5, 9, 12, 16, 20, 26, 34, 42, 50, and 52

,,
InterventionLiters (Least Squares Mean)
Day 1, minute 5 (n=135, 74, 74)Day 1, minute 15 (n=139, 75, 74)Day 1, minute 30 (n=143, 77, 74)Day 1, hour 1 (n=144, 76, 75)Day 1, hour 2 (n=144, 75, 75)Day 1, hour 3 (n=143, 74, 73)Day 1, hour 4 (n=144, 70, 74)Day 1, hour 6 (n=142, 71, 74)Day 1, hour 8 (n=137, 70, 75)Day1, hour 10 (n=134, 72, 75)Day 1, hour 12 (n=130, 69, 70)Day 1, hour 23, minute 15 (n=129, 71, 72)Day 1, hour 23, minute 45 (n=128, 74, 75)Day 15, minute 5 (n=135, 65, 73)Day 15, minute 15 (n=133, 70, 72)Day 15, minute 30 (n= 139, 70, 74)Day 15, hour 1 (n=140, 68, 74)Week 5, minute 5 (n=134, 66, 68)Week 5, minute 15 (n=136, 67, 70)Week 5, minute 30 (n=135, 67, 70)Week 9, minute 5 (n=128, 66, 70)Week 9, minute 15 (n=130, 66, 71)Week 9, minute 30 (n=130, 67, 71)Week 12, minute 5 (n=130, 69, 70)Week 12, minute 15 (n=129, 67, 66)Week 12, minute 30 (n=133, 69, 67)Week 12, hour 1 (n=132, 67, 69)Week 12, hour 2 (n=129, 65, 68)Week 12, hour 3 (n=126, 64, 69)Week 12, hour 4 (n=124, 64, 68)Week 12, hour 6 (n=123, 63, 69)Week 12, hour 8 (n=121, 64, 69)Week 12, hour 10 (n=124, 61, 69)Week 12, hour 12 (n=122, 58, 68)Week 12, hour 16 (n=109, 56, 57)Week 12, hour 22 (n=117, 60, 63)Week 12, hour 23, minute 15 (n=126, 66, 67)Week 12, hour 23, minute 45 (n=124, 65, 63)Week 16, minute 5 (n=123, 65, 64)Week 16, minute 15 (n=124, 65, 65)Week 16, minute 30 (n=125, 65, 65)Week 20, minute 5 (n=125, 66, 63)Week 20, minute 15 (n=124, 65, 63)Week 20, minute 30 (n=125, 65, 63)Week 26, minute 5 (n=123, 62, 64)Week 26, minute 15 (n=121, 61, 61)Week 26, minute 30 (n=125, 64, 64)Week 26, hour 1 (n=127, 64, 64)Week 26, hour 2 (n=124, 64, 63)Week 26, hour 3 (n=124, 64, 64)Week 26, hour 4 (n=124, 64, 62)Week 26, hour 23, minute 15 (n=120, 55, 61)Week 26, hour 23, minute 45 (n=117, 56, 61)Week 34, minute 5 (n=125, 62, 63)Week 34, minute 15 (n=123, 62, 63)Week 34, minute 30 (n=125, 62, 62)Week 34, hour 1 (n=125, 62, 63)Week 42, minute 5 (n=119, 61, 58)Week 42, minute 15 (n=123, 61, 58)Week 42, minute 30 (n=123, 61, 58)Week 50, minute 5 (n=120, 60, 57)Week 50, minute 15 (n=123, 60, 57)Week 50, minute 30 (n=123, 60, 58)Week 52, minute 5 (n=124, 60, 57)Week 52, minute 15 (n=122, 59, 58)Week 52, minute 30 (n=125, 62, 58)Week 52, hour 1 (n=125, 62, 57)Week 52, hour 2 (n=124, 61, 58)Week 52, hour 3 (n=123, 62, 56)Week 52, hour 4 (n=121, 60, 55)Week 52, hour 6 (n=118, 59, 54)Week 52, hour 8 (n=119, 59, 54)Week 52, hour 10 (n=119, 59, 55)Week 52, hour 12 (n=120, 58, 52)Week 52, hour 16 (n=117, 53, 46)Week 52, hour 22 (n=118, 60, 52)Week 52, hour 23, 15 minutes (n=121, 62, 57)Week 52, hour 23, 45 minutes (n=122, 61, 57)
Glycopyrronium Bromide 50 μg3.0273.0503.0553.1483.1793.1903.1383.1733.0713.1343.0302.9913.0143.0513.1033.1343.1523.1393.1653.2483.1953.1673.2313.0603.0813.0583.1643.1903.2403.1193.1583.0833.1303.0722.9332.9243.0913.0553.1563.1563.1983.0933.1123.1572.9943.0413.0543.0773.1103.2103.1113.0562.9983.0233.0163.0813.0723.0333.0223.0573.0223.0423.0942.9402.9602.9393.0313.0623.1083.0212.9862.9613.0002.8812.8572.8122.8882.855
Placebo to Glycopyrronium Bromide2.8262.8022.7522.7912.8022.8262.7832.8462.8042.8652.7092.8002.8172.7932.7902.8252.7702.8662.8502.8842.8262.8232.8212.7282.7402.6962.7372.7842.8642.7452.8522.7602.8602.7712.7012.6732.8622.8262.8642.8012.8152.7812.7702.7782.7002.6922.7002.6782.7712.8712.7912.8032.7522.7312.7312.6872.7032.7162.6952.7232.7312.7022.7312.6452.6402.6252.6172.7142.7162.6942.6902.6372.6872.6362.5422.6042.6782.607
Tiotropium 18 μg2.9562.9912.9793.0413.0493.1193.1023.1483.0743.1193.0122.9882.9943.0143.1033.0783.0603.0713.0923.1803.0973.1013.1493.0233.0183.0273.0983.1553.1463.0843.1203.0113.1173.0202.8802.8703.1103.0043.1043.0823.1122.9933.0293.0502.9542.9762.9943.0163.0803.1763.0862.9322.8952.8812.8982.9712.9633.0693.0653.0982.9632.9372.9852.8602.9352.9292.9803.0213.0532.9782.9822.9423.0122.8492.7722.7162.8522.797

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Trough FEV1 and FVC at Day 1 and Week 26

"Spirometry was conducted according to internationally accepted standards. Trough FEV1 was defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FEV1 readings. Mixed model used baseline FEV1, baseline ICS use, FEV1 prior to inhalation of SABA, and FEV1 45 minutes post-inhalation of SABA as covariates.~Trough FVC was defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FVC readings. Mixed model used baseline FVC, baseline ICS use, FEV1 prior to inhalation of SABA, and FEV1 45 minutes post-inhalation of SABA as covariates." (NCT01005901)
Timeframe: Day 1 and Week 26

,
InterventionLiters (Least Squares Mean)
Day 1: FEV1 (n = 508, 248)Week 26: FEV1 (n = 461, 217)Day 1: FVC (n = 508, 248)Week 26: FVC (n = 438, 208)
Glycopyrronium Bromide1.4141.3872.9012.867
Placebo1.3091.2752.7052.668

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Percentage of Nights With no Nighttime Awakenings Over the 26 Week Treatment Period

"The percentage of nights with no nighttime awakenings is defined as the total number of nights with no nighttime awakenings over the 26 week treatment period divided by the total number of night where diary recordings have been made.~Mixed model used baseline nighttime awakenings, baseline ICS use, FEV1 prior to inhalation of SABA, and FEV1 45 minutes post-inhalation of SABA as covariates." (NCT01005901)
Timeframe: 26 Weeks

Interventionpercentage of nights with no awakenings (Least Squares Mean)
Glycopyrronium Bromide55.96
Placebo54.37

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Percentage of Days With no Daytime Symptoms Over the 26 Week Treatment Period

"The percentage of days with no daytime symptoms is defined as the total number of days with no daytime symptoms over the 26 week treatment period divided by the total number of days where diary recordings have been made.~Mixed model used baseline daytime symptoms, baseline ICS use, FEV1 prior to inhalation of SABA, and FEV1 45 minutes post-inhalation of SABA as covariates." (NCT01005901)
Timeframe: 26 Weeks

Interventionpercentage of days with no symptoms (Least Squares Mean)
Glycopyrronium Bromide5.70
Placebo5.78

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Percentage of Days Able to Perform Usual Daily Activities Over the 26 Week Treatment Period

"The percentage of days able to perform usual daily activities is defined as the total number of days able to perform usual activities over the 26 week treatment period divided by the total number of days where diary recordings have been made.~Mixed model used baseline ability to perform usual daily activities, baseline ICS use, FEV1 prior to inhalation of SABA, and FEV1 45 minutes post-inhalation of SABA as covariates." (NCT01005901)
Timeframe: 26 Weeks

Interventionpercentage of days (Least Squares Mean)
Glycopyrronium Bromide40.31
Placebo35.19

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Change From Baseline in the Mean Number of Puffs Per Day of Rescue Medication Over the Study Duration (Baseline to Week 26)

Participants recorded the number of puffs of rescue medication taken in the previous 12 hours in the morning and evening. The total number of puffs of rescue medication per day over the full 26 weeks was calculated and divided by the total number of days with non-missing rescue medication data to derive the mean daily number of puffs of rescue medication taken for the patient. (NCT01005901)
Timeframe: 26 weeks

InterventionPuffs per day (Least Squares Mean)
Glycopyrronium Bromide-1.21
Placebo-0.75

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Mean Daily Total Symptom Score Over the 26 Week Treatment Period

"The daily symptom score was calculated as the sum of the worst of the morning and evening assessments for each symptom (symptoms, cough, wheeze, sputum color/production, and breathlessness). The score can range from 0 to 18 with 0 indicating no symptoms. The higher the score, the worse the symptomatic status. A negative change (lower number) indicates improvement.~Mixed model used baseline symptom variables, baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates." (NCT01005901)
Timeframe: 26 Weeks

Interventionunits on a scale (Least Squares Mean)
Glycopyrronium Bromide-1.54
Placebo-1.18

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Quality of Life Assessment With St. George's Respiratory Questionnaire (SGRQ) Total Score After 26 Weeks of Treatment

SGRQ is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity, and impacts. The lowest possible value is zero and the highest 100. Higher values correspond to greater impairment in quality of life. Mixed model used baseline SGRQ, baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: 26 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium Bromide39.50
Placebo42.31

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Forced Vital Capacity (FVC) at Each Time-point on Day 1 and Week 26

Spirometry was conducted according to internationally accepted standards. FVC was calculated at each time point up to 4 hours post-dose and at 23 hours 15 min and 23 hours 45 min, by visit. Mixed model used baseline FVC, baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: Day 1 and Week 26

,
InterventionLiters (Least Squares Mean)
Day 1: 5 min (n = 497, 240)Day 1: 15 min (n = 503, 249)Day 1: 30 min (n = 511, 252)Day 1: 1hour (n = 513, 253)Day 1: 2 hours (n = 514, 251)Day 1: 3 hours (n = 519, 248)Day 1: 4 hours (n = 514, 247)Day 1: 23 hours 15 min (n = 499, 244)Day 1: 23 hours 45 min (n = 498, 244)Week 26: Pre-dose trough (n = 447, 208)Week 26: -45 min (n = 447, 208)Week 26: -15 min (n = 443, 205)Week 26: 5 min (n = 439, 208)Week 26: 15 min (n = 435, 205)Week 26: 30 min (n = 440, 207)Week 26: 1 hour (n = 438, 206)Week 26: 2 hours (n = 438, 203)Week 26: 3 hours (n = 439, 204)Week 26: 4 hours (n = 438, 205)Week 26: 23 hours 15 min (n = 434, 206)Week 26: 23 hours 45 min (n = 434, 206)
Glycopyrronium Bromide2.8872.9432.9483.0193.0863.0963.0642.8952.9072.8272.8592.7982.8912.8952.8852.9382.9773.0162.9622.8842.859
Placebo2.6752.6602.6372.6692.7542.7832.7602.6932.7182.6232.6582.5892.6392.6602.6032.6252.6872.7422.7092.6732.669

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FEV1 at Each Time-point on Day 1 and Week 26

Spirometry was conducted according to internationally accepted standards. FEV1 was measured at all time points up to 4 hours post-dose, and at 23 hours 15 min and 23 hours 45 min, by visit. Mixed model used baseline FEV1,baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: Day 1 and Week 26

,
InterventionLiters (Least Squares Mean)
Day 1: 5 min (n = 497, 240)Day 1: 15 min (n = 503, 249)Day 1: 30 min (n = 511, 252)Day 1: 1 hour (n = 513, 253)Day 1: 2 hours (n = 514, 251)Day 1: 3 hours (n = 519, 248)Day 1: 4 hours (n = 514, 247)Day 1: 23 hours 15 min (n = 499, 244)Day 1: 23 hours 45 min (n = 498, 244)Week 26: pre-dose trough (n = 447, 208)Week 26: -45 min (n = 447, 208)Week 26: -15 min (n = 443, 205)Week 26: 5 min (n = 439, 208)Week 26: 15 min (n = 435, 205)Week 26: 30 min (n = 440, 207)Week 26: 1 hour (n = 438, 206)Week 26: 2 hours (n = 438, 203)Week 26: 3 hours (n = 439, 204)Week 26: 4 hours (n = 438, 205)Week 26: 23 hours 15 min (n = 434, 206)Week 26: 23 hours 45 min (n = 434, 206)
Glycopyrronium Bromide1.3881.4351.4721.4931.5621.5441.5481.4001.4281.3711.3731.3681.4091.4271.4331.4591.5081.5041.4891.3861.396
Placebo1.2951.2921.2991.2961.3551.3491.3651.2891.3281.2561.2561.2521.2551.2691.2591.2511.2991.2991.3121.2671.282

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FEV1 Area Under the Curve (AUC) (5 Min - 12 Hour) at Day 1, Week 12 and Week 26

The standardized (with respect to the length of time) area under the curve (AUC) for FEV1 was calculated using trapezoidal rule between 5 min and 12 h post dose at Week 1 Day 1, Week 12 and Week 26 for every patient in the serial spirometry subgroup. Mixed model used baseline FEV1,baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: Day 1, Week 12 and Week 26

,
InterventionLiters (Least Squares Mean)
Day 1 (n = 169, 83)Week 12 (n = 153, 75)Week 26 (n = 149, 70)
Glycopyrronium Bromide1.4751.4331.445
Placebo1.3201.2841.238

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FEV1 Area Under Curve (AUC) (5 Min - 23 Hour 45 Min) at Week 12 and Week 26

The standardized (with respect to the length of time) area under the curve (AUC) for FEV1 was calculated using trapezoidal rule between 5 min and 23 h 45 min post dose at week12/week 13and week 26/week 27 where available for every patient in the serial spirometry subgroup. Mixed model used baseline FEV1,baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: Week 12 and Week 26

,
InterventionLiters (Least Squares Mean)
Week 12 (n = 153, 75)Week 26 (n = 149, 70)
Glycopyrronium Bromide1.4011.412
Placebo1.2681.213

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Change in 24-hourly Mean Heart Rate at Day 1, Week 12 and Week 26

The mean heart rate was collected with a 24 hour Holter monitor in a sub-set of the safety population. The change between baseline and day 1, week 12 and week 26 was calculated. The analysis of the Holter recordings was performed by a central facility. Data on heart rate, heart rate variability, supraventricular and ventricular ectopy were collected and assessed. (NCT01005901)
Timeframe: Baseline, Day 1, Week 12 and Week 26

,
Interventionbeats per minute (Mean)
Day 1: (n = 42, 23)Week 12: (n = 42, 20)Week 26: (n = 37, 22)
Glycopyrronium Bromide-1.77-1.99-4.40
Placebo-1.28-1.70-2.60

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Trough Forced Expiratory Volume in 1 Second (FEV1) at 12 Weeks

Spirometry was conducted according to internationally accepted standards. Trough FEV1 was defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FEV1 readings. Mixed model used baseline FEV1,baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: 12 weeks

InterventionLiters (Least Squares Mean)
Glycopyrronium Bromide1.408
Placebo1.301

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Transition Dyspnea Index (TDI) Focal Score After 26 Weeks of Treatment

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. Mixed model used baseline TDI, baseline inhaled corticosteroid (ICS) use, FEV1 prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. (NCT01005901)
Timeframe: 26 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium Bromide1.84
Placebo0.80

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Time to First Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation During 26 Weeks of Treatment

The time to the first moderate or severe COPD exacerbation was the study day on which the patient experienced first moderate or severe COPD exacerbation. COPD exacerbations are considered to be moderate if treatment with systemic corticosteroids and/or antibiotics was required. COPD exacerbations are considered to be severe if treatment for moderate severity and hospitalization were required. (NCT01005901)
Timeframe: 26 weeks

InterventionDays (Median)
Glycopyrronium BromideNA
PlaceboNA

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Rate of Moderate or Severe COPD Exacerbations Over the 26 Week Treatment Period

One overall rate is calculated for the entire study population. Rate is the number of moderate or severe exacerbations per year = total number of moderate or severe exacerbations for all participants/total number of treatment years for all participants. COPD exacerbations were considered to be moderate if treatment with systemic corticosteroids and/or antibiotics was required. COPD exacerbations were considered to be severe if treatment for moderate severity and hospitalization were required. (NCT01005901)
Timeframe: 26 weeks

Interventionexacerbations per year (Number)
Glycopyrronium Bromide0.43
Placebo0.59

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Number of Participants With Adverse Events, Serious Adverse Events or Death

Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal lab finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgments of the investigators represent significant hazards. (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
Adverse eventsSerious adverse eventsDeath
NVA237102160
Tiotropium3360

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Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Timepoint Over the Whole Treatment Period

Clinically notable vital sign values were: pulse rate - low, <40 bpm or <=50 bpm and decrease from baseline >=15bpm; pulse rate high, >130 bpm or >=120bpm and increase from baseline >=15 bpm. Systolic blood pressure - low, <75 mmHg or <=90 mmHg and decrease from baseline >=20 mmHg; high, >200 mmHg or >=180 mmHg and increase from baseline >=20 mmHg. Diastolic blood pressure - low, <40 mmHg or <=50 mmHg and decrease from baseline >=15 mmHg; high, >115 mmHg or >=105 mmHg and increase from baseline >=15 mmHg. (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
Pulse rate - lowPulse rate - highPulse rate - low or highSystolic blood pressure - lowSystolic blood pressure - highSystolic blood pressure - low or highDiastolic blood pressure - lowDiastolic blood pressure - highDiastolic blood pressure - low or high
NVA237000011123
Tiotropium101000000

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Change in St. George Respiratory Questionnaire From Baseline

SGRQ is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity, and impacts. The lowest possible value is zero and the highest 100. Higher values correspond to greater impairment in quality of life. (NCT01119937)
Timeframe: Weeks 12, 24, 36, 52

,
Interventionscore on a scale (Mean)
Week 12Week 24Week 36Week 52
NVA237-2.57-1.77-2.54-2.68
Tiotropium-2.31-3.24-0.930.36

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Change in Pre-dose FVC From Baseline

Pre-dose FVC is defined as the average of the measurements at 45 and 15 minutes pre-dose. (NCT01119937)
Timeframe: Weeks 12, 24, 36 and 52

,
Interventionliters (Mean)
Week 12Week 24Week 36 (n = 106, 36)Week 52 (n = 103, 33)
NVA2370.2210.2180.2080.195
Tiotropium0.2200.1790.1460.126

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Change in Pre-dose FEV1 From Baseline

Pre-dose FEV1 is defined as the average of the measurements at 45 and 15 minutes pre-dose. (NCT01119937)
Timeframe: Weeks 12, 24, 36 and 52

,
Interventionliters (Mean)
Week 12Week 24Week 36 (n = 106, 36)Week 52 (n = 103, 33)
NVA2370.1010.0940.0840.068
Tiotropium0.1730.1440.1120.127

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Change From Baseline in Mean Daily Number of Puffs of Rescue Medication Over the Whole Treatment Period

Patients recorded rescue medication use in a paper patient diary. If a patient required the use of salbutamol as rescue medication due to an increase in COPD symptoms, the number of inhalations (puffs) taken was recorded in the patient diary. (NCT01119937)
Timeframe: 52 weeks

Interventionchange in puffs (Mean)
NVA237-0.16
Tiotropium-0.27

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Number of Patients With Notable Change From Baseline in Fridericia's QTc Values at Any Timepoint Over the Whole Treatment Period

Clinically notable change from baseline was and increase from baseline of 30 or greater milliseconds (ms). (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
Increase from baseline 30 to 60 msIncrease from baseline >60 ms
NVA23762
Tiotropium10

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Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period

Clinically notable hematology values were: hemoglobin - male <11.5g/dL, female <9.5 g/dL; hematocrit - male <37%, female <32%; white cell count - <2800µL or >16000µL; platelets - <7.5 10*4/µL or >70.0 10*4/µL (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
Hemoglobin - male (n = 121, 38)Hemoglobin - female (n = 121, 38)Hematocrit - male (n = 121, 38)Hematocrit - female (n = 121, 38)White cell count - <2800/µLWhite cell count - >16000/µLPlatelets - <7.5 10*4/µLPlatelets - >70.0 10*4/µL
NVA23730300010
Tiotropium20401000

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Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Timepoint Over the Whole Treatment Period

Clinically notable biochemistry values were: total protein - <4.0 g/dL or >9.5 g/dL; albumin <2.5 g/dL; bilirubin (total) >1.9 mg/dL; BUN >27 mg/dL; creatinine >1.99 mg/dL; AST >3 x ULN U/L; ALT >3 x ULN U/L; ALP >3 x ULN U/L; y-GTP >3 x ULN U/L; sodium <125 mEq/L or >160 mEq/L; potassium <3.0 mEq/L or >6.0 mEq/L; glucose <51.0 mg/dL or >180.0 mg/dL (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
Total protein - <4.0 g/dLTotal protein - >9.5 g/dLAlbumin - <2.5 g/dLBilirubin (total) - >1.9 mg/dLBUN - >27 mg/dLCreatinine - >1.99 mg/dLAST - >3 x ULN U/LALT - >3 x ULN U/LALP - >3 x ULN U/LY-GTP - >3 x ULN U/LSodium - <125 mEq/LSodium - >160 mEq/LPotassium - <3.0 mEq/LPotassium - >6.0 mEq/LGlucose - <51.0 mg/dLGlucose - >180.0 mg/dL
NVA23700023010050010011
Tiotropium0000000014000003

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Number of Patients With Moderate or Severe COPD Exacerbations

Moderate COPD exacerbations were defined as: worsening of 2 or more of the following major symptoms for at least 2 consecutive days - dyspnea, sputum volume and sputum purulence; OR a worsening of any 1 major symptom with any 1 of the following minor symptoms for at least 2 consecutive days - sore throat, colds, fever without other cause, increased cough or increased wheeze, requiring treatment with systemic glucocorticosteroids or antibiotics or both. Severe COPD exacerbations were defined as: conditions for Moderate COPD exacerbation and hospitalization was required. (NCT01119937)
Timeframe: 52 weeks

,
Interventionparticipants (Number)
0 exacerbations1 exacerbation2 exacerbations3 exacerbations> = 4 exacerbations
NVA2379917511
Tiotropium315301

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Time From Randomization Until the Start of the First Moderate or Severe COPD Exacerbation

Moderate COPD exacerbations were defined as: worsening of 2 or more of the following major symptoms for at least 2 consecutive days - dyspnea, sputum volume and sputum purulence; OR a worsening of any 1 major symptom with any 1 of the following minor symptoms for at least 2 consecutive days - sore throat, colds, fever without other cause, increased cough or increased wheeze, requiring treatment with systemic glucocorticosteroids or antibiotics or both. Severe COPD exacerbations were defined as: conditions for Moderate COPD exacerbation and hospitalization was required. Participants who withdraw from the study and do not experience a moderate or severe exacerbation are censored at the date of withdrawal. Participants who complete the study and do not experience a moderate or severe exacerbation are censored at the completion visit date. (NCT01119937)
Timeframe: 52 weeks

Interventiondays (Number)
NVA237362
Tiotropium359

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Trough Forced Vital Capacity on Days 1, 7 and 14

"Trough Forced Vital Capacity (FVC) on Days 1, 7 and 14. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry. (see Outcome Measure #23).~Trough FVC was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values." (NCT01119950)
Timeframe: Days 1, 7 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=88, 92, 91, 90, 94, 94, 87, 86)Day 7 (n=87, 92, 90, 91, 95, 93, 85, 87)Day 14 (n= 85, 90, 91, 88, 94, 93, 81, 84)
NVA237 100.0 µg q.d.2.9442.9772.941
NVA237 12.5 µg b.i.d.2.9972.9912.965
NVA237 12.5 µg q.d.2.8952.9822.958
NVA237 25.0 µg b.i.d.2.9562.9932.960
NVA237 25.0 µg q.d.3.0633.1353.000
NVA237 50.0 µg b.i.d.3.0883.1143.113
NVA237 50.0 µg q.d.3.0173.0723.003
Placebo2.7792.7592.744

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours at Day 28 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-24 hours at day 28 of treatment was calculated from measurements taken at 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28.~AUC FEV1 was measured in response to all doses administered (see Outcome Measure #20). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28

InterventionPercentage of maximal response * hours (Mean)
NVA237 12.5 µg q.d.28.9
NVA237 25.0 µg q.d.44.8
NVA237 12.5 µg b.i.d.49.0
NVA237 50.0 µg q.d.61.9
NVA237 25.0 µg b.i.d.65.7
NVA237 100.0 µg q.d.76.4
NVA237 50.0 µg b.i.d.79.3

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second at 12 Hours at Day 28 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response within different doses/regimens of NVA237 was measured using FEV1 at 12 hours on day 28 of treatment.~FEV1 was measured in response to all doses administered (see Outcome Measure #22). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 12 hours on day 28

InterventionPercentage of maximal response (Mean)
NVA237 12.5 µg q.d.27.1
NVA237 25.0 µg q.d.42.7
NVA237 12.5 µg b.i.d.35.5
NVA237 50.0 µg q.d.59.8
NVA237 25.0 µg b.i.d.52.4
NVA237 100.0 µg q.d.74.9
NVA237 50.0 µg b.i.d.68.7

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Percentage of the Maximal Response of NVA237 Doses on Forced Vital Capacity at Day 28 of Treatment

"Percentage of the maximal response of NVA237 within different doses/regimens of NVA237 on Forced Vital Capacity (FVC) was measured at day 28 of treatment. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible.~FVC at day 28 of treatment was measured via spirometry (see Outcome Measure #24). All FVC responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FVC data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: day 28

InterventionPercentage of maximal response (Mean)
NVA237 12.5 µg q.d.23.3
NVA237 25.0 µg q.d.37.4
NVA237 12.5 µg b.i.d.53.6
NVA237 50.0 µg q.d.54.0
NVA237 25.0 µg b.i.d.69.3
NVA237 100.0 µg q.d.69.7
NVA237 50.0 µg b.i.d.81.4

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Percentage of the Maximal Response of NVA237 Doses on Peak Forced Expiratory Volume in One Second at Day 28 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Peak FEV1 is the maximum FEV1 recorded in a pre-determined period of time.~Percentage of the maximal response of NVA237 within different doses/regimens of NVA237 on Peak FEV1 was measured at day 28 of treatment.~Peak FEV1 was measured in response to all doses administered (see Outcome Measure #23). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: day 28

InterventionPercentage of maximal response (Mean)
NVA237 12.5 µg q.d.53.3
NVA237 25.0 µg q.d.69.2
NVA237 12.5 µg b.i.d.61.1
NVA237 50.0 µg q.d.81.5
NVA237 25.0 µg b.i.d.75.6
NVA237 100.0 µg q.d.89.6
NVA237 50.0 µg b.i.d.85.8

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Trough Forced Expiratory Volume in One Second by Treatment at Day 28

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values." (NCT01119950)
Timeframe: Day 28

InterventionLiters (Mean)
NVA237 12.5 ug q.d.1.319
NVA237 25 ug q.d.1.368
NVA237 12.5 ug b.i.d.1.354
NVA237 50 ug q.d.1.340
NVA237 25 ug b.i.d.1.384
NVA237 100 ug q.d.1.410
NVA237 50 ug b.i.d.1.493
Placebo1.268

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Trough Forced Vital Capacity After 28 Days of Treatment

Forced Vital Capacity (FVC) after 28 days of treatment. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry. Trough FVC was defined as the mean of the FVC values measured at 23 hours 15 mins and 23 hours 45 mins post-dose. (NCT01119950)
Timeframe: 23 hours 15 mins and 23 hours 45 mins post-dose on Day 28

InterventionLiters (Mean)
NVA237 12.5 µg q.d.2.939
NVA237 25.0 µg q.d.3.007
NVA237 12.5 µg b.i.d.2.954
NVA237 50.0 µg q.d.2.973
NVA237 25.0 µg b.i.d.3.041
NVA237 100.0 µg q.d.2.974
NVA237 50.0 µg b.i.d.3.080
Placebo2.703

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Forced Expiratory Volume in One Second Area Under the Curve 0-12 Hours at Day 1 and 14 of Treatment

Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses was calculated on FEV1 Area Under the Curve (AUC) 0-12 hours from measurements taken at at 5 min,15 min, 1,2,3,4,6,8,10 hours, 11h 55 min (postdose) on days 1 and 14. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time. (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11h 55 min (postdose) on days 1 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 87, 90)Day 14 (n=86, 92, 91, 91, 95, 93, 84, 86)
NVA237 100.0 µg q.d.1.4311.427
NVA237 12.5 µg b.i.d.1.3791.357
NVA237 12.5 µg q.d.1.3821.360
NVA237 25.0 µg b.i.d.1.3641.378
NVA237 25.0 µg q.d.1.4251.416
NVA237 50.0 µg b.i.d.1.4981.494
NVA237 50.0 µg q.d.1.4301.406
Placebo1.2891.281

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Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours on Days 1 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~FEV1 Area Under the Curve (AUC) measurements were taken at 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on days 1 and 14 of treatment. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time." (NCT01119950)
Timeframe: 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on days 1 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n= 89,94,93,92,96,96,87,90)Day 14 (n= 86,92,91,91,95,93,84,86)
NVA237 100.0 µg q.d.1.3761.386
NVA237 12.5 µg b.i.d.1.3541.324
NVA237 12.5 µg q.d.1.3181.306
NVA237 25.0 µg b.i.d.1.3361.335
NVA237 25.0 µg q.d.1.3701.353
NVA237 50.0 µg b.i.d.1.4661.449
NVA237 50.0 µg q.d.1.3611.348
Placebo1.2561.253

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Forced Expiratory Volume in One Second Area Under the Curve 0-4 Hours on Days 1, 7 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~FEV1 Area Under the Curve (AUC) measurements were taken at 5 min, 15 min, 1,2,3,4 hours (postdose) on days 1, 7 and 14 of treatment. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4 hours (postdose) on Days 1, 7 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=89,94,93,91,96,96,86,89)Day 7 (n=87,93,90,92,95,94,85,89)Day 14 (n=86,92,91,91,95,93,84,86)
NVA237 100.0 µg q.d.1.4531.4531.460
NVA237 12.5 µg b.i.d.1.4211.3971.390
NVA237 12.5 µg q.d.1.4281.4031.451
NVA237 25.0 µg b.i.d.1.4111.3901.429
NVA237 25.0 µg q.d.1.4831.4831.473
NVA237 50.0 µg b.i.d.1.5331.5371.545
NVA237 50.0 µg q.d.1.4691.4321.468
Placebo1.3121.3101.314

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Forced Expiratory Volume in One Second Area Under the Curve at Different Time Points (0-4 Hours, 0-8 Hours, 0-12 Hours, 12-24 Hours)

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~FEV1 Area Under the Curve (AUC) measurements were taken at: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose). FEV1 AUC was calculated as the sum of trapezoids divided by the length of time." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28

,,,,,,,
InterventionLiters (Mean)
AUC 0-4h (n=82,90,91,89,92,91,82,82)AUC 0-8h (n=82,90,91,90,92,91,82,82)AUC 0-12h (n=82,90,91,90,92,91,82,82)AUC 12-24h (n=82,90,91,89,92,91,81,82)
NVA237 100.0 µg q.d.1.4901.4611.4421.350
NVA237 12.5 µg b.i.d.1.4141.3921.3621.280
NVA237 12.5 µg q.d.1.4151.3861.3641.251
NVA237 25.0 µg b.i.d.1.4171.3971.3751.299
NVA237 25.0 µg q.d.1.4781.4471.4161.287
NVA237 50.0 µg b.i.d.1.5531.5271.5051.421
NVA237 50.0 µg q.d.1.4311.3971.3771.264
Placebo1.3151.3051.2851.208

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Forced Expiratory Volume in One Second at 12 Hours on Days 1 and 14 of Treatment

Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses on FEV1 at 12 hours was measured on days 1 and 14. (NCT01119950)
Timeframe: Days 1 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=83, 90, 91, 85, 89, 90, 83, 81)Day 14 (n=84, 91, 88, 90, 90, 92, 78, 83)
NVA237 100.0 µg q.d.1.3741.389
NVA237 12.5 µg b.i.d.1.3271.303
NVA237 12.5 µg q.d.1.3191.290
NVA237 25.0 µg b.i.d.1.2991.329
NVA237 25.0 µg q.d.1.3641.356
NVA237 50.0 µg b.i.d.1.4391.469
NVA237 50.0 µg q.d.1.3451.329
Placebo1.2441.268

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Forced Expiratory Volume in One Second of Area Under the Curve 0-8 Hours Days 1, 7, and 14

Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-8 was calculated from measurements taken at 5 min,15 min, 1,2,3,4,6,8 hours (postdose) on days 1, 7, and 14. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time. (NCT01119950)
Timeframe: at 5 min,15 min, 1,2,3,4,6,8 hours (postdose) on days 1, 7 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 87, 90)Day 7 (n= 87, 93, 91, 92, 95, 94, 85, 89)Day 14 (n=86, 92, 91, 91, 95, 93, 84, 86)
NVA237 100.0 µg q.d.1.4461.4331.442
NVA237 12.5 µg b.i.d.1.4011.3751.375
NVA237 12.5 µg q.d.1.4001.3861.381
NVA237 25.0 µg b.i.d.1.3901.3731.400
NVA237 25.0 µg q.d.1.4501.4621.441
NVA237 50.0 µg b.i.d.1.5191.5161.514
NVA237 50.0 µg q.d.1.4511.4091.435
Placebo1.3011.2931.293

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Forced Expiratory Volume in One Second of Area Under the Curve 12-24 Hours Over Days 1, and 14 of Treatment

Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 on FEV1 Area under the curve (AUC) 12-24 hours was calculated from measurements taken at 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on Days 1 and 14. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time. (NCT01119950)
Timeframe: 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on Days 1 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=89, 94, 93, 92, 96, 96, 87, 90)Day 14 (n= 86, 92, 91, 91, 95, 93, 84, 86)
NVA237 100.0 µg q.d.1.3221.344
NVA237 12.5 µg b.i.d.1.3291.290
NVA237 12.5 µg q.d.1.2571.251
NVA237 25.0 µg b.i.d.1.3061.291
NVA237 25.0 µg q.d.1.3151.289
NVA237 50.0 µg b.i.d.1.4371.406
NVA237 50.0 µg q.d.1.2951.291
Placebo1.2241.225

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Mean Daily Use of Rescue Medication by Treatment at Different Time Points

Mean daily use of rescue medication by treatment and time points. Baseline was defined as the average of the total number of puffs of rescue medication during the week prior to treatment start, divided by the total number of days with non-missing rescue data during that week, then puffs were counted during weeks 1, 2, 3 and 4 postdose. (NCT01119950)
Timeframe: Baseline, Weeks 1, 2, 3 and 4

,,,,,,,
InterventionNumber of Puffs (Mean)
Baseline (n=89, 95, 95, 92, 96, 96, 86, 91)Week 1 (n=89, 95, 95, 91, 96, 96, 86, 90)Week 2 (n=86, 94, 94, 91, 95, 93, 84, 89)Week 3 (n= 86, 93, 94, 89, 93, 93, 83, 87)Week 4 (n=86, 92, 94, 88, 93, 93, 82, 85)
NVA237 100.0 µg q.d.4.812.532.592.752.65
NVA237 12.5 µg b.i.d.3.832.102.222.292.42
NVA237 12.5 µg q.d.4.162.412.742.752.91
NVA237 25.0 µg b.i.d.3.472.132.082.232.32
NVA237 25.0 µg q.d.4.162.232.202.402.52
NVA237 50.0 µg b.i.d.4.252.542.822.692.78
NVA237 50.0 µg q.d.4.452.362.382.372.46
Placebo4.622.943.323.343.41

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Peak Forced Expiratory Volume in One Second on Days 1, 7 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Peak FEV1 is the maximum FEV1 recorded in a pre-determined period of time.~Percentage of the maximal response of NVA237 doses on Peak FEV1 was measured on days 1, 7 and 14 of treatment." (NCT01119950)
Timeframe: Days 1, 7, and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 86, 89)Day 7 (n=87, 93, 90, 92, 95, 94, 85, 89)Day 14 (n=86, 92, 91, 91, 95, 93, 84, 86)
NVA237 100.0 µg q.d.1.5211.5131.528
NVA237 12.5 µg b.i.d.1.4941.4551.465
NVA237 12.5 µg q.d.1.5031.4591.487
NVA237 25.0 µg b.i.d.1.4831.4481.506
NVA237 25.0 µg q.d.1.5581.5401.547
NVA237 50.0 µg b.i.d.1.5971.5981.615
NVA237 50.0 µg q.d.1.5411.5011.537
Placebo1.3781.3641.380

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Percentage of the Maximal Effect of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours on Days 1 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-24 hours, was calculated from measurements taken at 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on days 1 and 14.~FEV1 AUC 0-24 hours was measured on days 1 and 14 of treatment in response to all doses administered (see Outcome Measure #26). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on days 1 and 14

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
Day 1 (n= 89,94,93,92,96,96,87)Day 14 (n= 86,92,91,91,95,93,84)
NVA237 100.0 µg q.d.83.276.4
NVA237 12.5 µg b.i.d.59.549.0
NVA237 12.5 µg q.d.38.328.9
NVA237 25.0 µg b.i.d.74.665.7
NVA237 25.0 µg q.d.55.444.8
NVA237 50.0 µg b.i.d.85.479.3
NVA237 50.0 µg q.d.71.361.9

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-12 Hours at Day 1 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses was calculated on FEV1 Area Under the Curve (AUC) 0-12 hours from measurements taken at at 5 min,15 min, 1,2,3,4,6,8,10 hours, 11h 55 min (postdose) on days 1 and 14 in response to all doses administered (see Outcome Measure #29).~All AUC FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11h 55 min (postdose) on days 1 and 14

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 87)Day 14 (n=86, 92, 91, 91, 95, 93, 84)
NVA237 100.0 µg q.d.88.784.8
NVA237 12.5 µg b.i.d.58.850.5
NVA237 12.5 µg q.d.49.541.1
NVA237 25.0 µg b.i.d.74.167.1
NVA237 25.0 µg q.d.66.258.3
NVA237 50.0 µg b.i.d.85.180.3
NVA237 50.0 µg q.d.79.673.6

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve 0-4 Hours on Days 1, 7 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-4 hours was calculated from measurements taken at 5 min,15 min, 1,2,3,4 hours (postdose) on Days 1, 7 and 14, in response to all doses administered (see Outcome Measure #27).~All AUC FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4 hours (postdose) on Days 1, 7 and 14

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
Day 1 (n=89,94,93,91,96,96,86)Day 7 (n=87,93,90,92,95,94,85)Day 14 (n=86,92,91,91,95,93,84)
NVA237 100.0 µg q.d.91.188.388.3
NVA237 12.5 µg b.i.d.66.158.958.9
NVA237 12.5 µg q.d.58.450.850.8
NVA237 25.0 µg b.i.d.79.173.773.7
NVA237 25.0 µg q.d.73.266.966.9
NVA237 50.0 µg b.i.d.88.084.484.4
NVA237 50.0 µg q.d.84.179.779.7

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second Area Under the Curve at Different Time Points (0-4 Hours, 0-8 Hours, 0-12 Hours, 12-24 Hours) on Day 28

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-4 Hours, 0-8 Hours, 0-12 Hours, 12-24 Hours were calculated from measurements taken at: 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28.~AUC FEV1 was measured in response to all doses administered (see Outcome Measure #21). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
AUC 0-4h (n=82,90,91,89,92,91,82)AUC 0-8h (n=82,90,91,90,92,91,82)AUC 0-12h (n=82,90,91,90,92,91,82)AUC 12-24h (n=82,90,91,89,92,91,81)
NVA237 100.0 µg q.d.88.387.184.871.2
NVA237 12.5 µg b.i.d.58.955.550.556.6
NVA237 12.5 µg q.d.50.845.841.125.6
NVA237 25.0 µg b.i.d.73.771.467.171.4
NVA237 25.0 µg q.d.66.962.858.340.1
NVA237 50.0 µg b.i.d.84.483.380.382.4
NVA237 50.0 µg q.d.79.777.173.656.4

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second at 12 Hours on Days 1 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses on FEV1 at 12 hours was measured on days 1 and 14.~FEV1 was measured in response to all doses administered (see Outcome Measure #31). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: Days 1 and 14

,,,,,,
InterventionPercentage of maximal response (Mean)
Day 1 (n=83, 90, 91, 85, 89, 90, 83)Day 14 (n=84, 91, 88, 90, 90, 92, 78)
NVA237 100.0 µg q.d.81.274.9
NVA237 12.5 µg b.i.d.44.435.5
NVA237 12.5 µg q.d.35.127.1
NVA237 25.0 µg b.i.d.61.552.4
NVA237 25.0 µg q.d.52.042.7
NVA237 50.0 µg b.i.d.76.166.7
NVA237 50.0 µg q.d.68.459.8

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second of Area Under the Curve 0-8 Hours Days 1, 7, and 14

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses on FEV1 Area Under the Curve (AUC) 0-8 was calculated from measurements taken at 5 min,15 min, 1,2,3,4,6,8 hours (postdose) on days 1, 7, and 14.~AUC FEV1 was measured in response to all doses administered (see Outcome Measure #28). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: at 5 min,15 min, 1,2,3,4,6,8 hours (postdose) on days 1, 7 and 14

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 87)Day 7 (n= 87, 93, 91, 92, 95, 94, 85)Day 14 (n=86, 92, 91, 91, 95, 93, 84)
NVA237 100.0 µg q.d.90.587.187.1
NVA237 12.5 µg b.i.d.63.655.555.5
NVA237 12.5 µg q.d.54.245.845.8
NVA237 25.0 µg b.i.d.77.871.471.4
NVA237 25.0 µg q.d.70.362.862.8
NVA237 50.0 µg b.i.d.87.583.383.3
NVA237 50.0 µg q.d.82.677.177.1

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Percentage of the Maximal Response of NVA237 Doses on Forced Expiratory Volume in One Second of Area Under the Curve 12-24 Hours Over Days 1, and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 on FEV1 Area under the curve (AUC) 12-24 hours was calculated from measurements taken at 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on Days 1 and 14.~AUC FEV1 was measured in response to all doses administered (see Outcome Measure #30). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on Days 1 and 14

,,,,,,
InterventionPercentage of maximal response* hours (Mean)
Day 1 (n=89, 94, 93, 92, 96, 96, 87)Day 14 (n= 86, 92, 91, 91, 95, 93, 84)
NVA237 100.0 µg q.d.69.371.2
NVA237 12.5 µg b.i.d.54.456.6
NVA237 12.5 µg q.d.23.925.6
NVA237 25.0 µg b.i.d.69.571.4
NVA237 25.0 µg q.d.37.940.1
NVA237 50.0 µg b.i.d.81.182.4
NVA237 50.0 µg q.d.54.156.4

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Percentage of the Maximal Response of NVA237 Doses on Peak Forced Expiratory Volume in One Second on Days 1, 7 and 14 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Peak FEV1 is the maximum FEV1 recorded in a pre-determined period of time.~Percentage of the maximal response of NVA237 doses on Peak FEV1 was measured on days 1, 7 and 14 of treatment.~Peak FEV1 was measured in response to all doses administered (see Outcome Measure #32). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response." (NCT01119950)
Timeframe: Days 1, 7, and 14

,,,,,,
InterventionPercentage of maximal response (Mean)
Day 1 (n=89, 94, 93, 91, 96, 96, 86)Day 7 (n=87, 93, 90, 92, 95, 94, 85)Day 14 (n=86, 92, 91, 91, 95, 93, 84)
NVA237 100.0 µg q.d.92.389.689.6
NVA237 12.5 µg b.i.d.68.961.161.1
NVA237 12.5 µg q.d.61.753.353.3
NVA237 25.0 µg b.i.d.81.375.675.6
NVA237 25.0 µg q.d.76.069.269.2
NVA237 50.0 µg b.i.d.89.585.885.8
NVA237 50.0 µg q.d.86.181.581.5

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Percentage of the Maximal Response of NVA237 Doses on Trough Forced Expiratory Volume in One Second at Days 1, 7 and 14

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Percentage of the maximal response of NVA237 doses on Trough FEV1 was measured on Days 1, 7 and 14.~Through FEV1 was measured in response to all doses administered (see Outcome Measure #25). All FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All FEV1 data are reported as a percentage of the theoretical maximal response.~Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values." (NCT01119950)
Timeframe: Days 1, 7 and 14

,,,,,,
InterventionPercentage of maximal response (Mean)
Day 1 (n= 88,92,91, 90, 94, 94, 87)Day 7 (n= 87,92,90, 91, 95, 93, 85)Day 14 (n= 85,90,91, 88, 94, 93, 81)
NVA237 100.0 µg q.d.74.373.073.0
NVA237 12.5 µg b.i.d.63.361.661.6
NVA237 12.5 µg q.d.28.527.127.1
NVA237 25.0 µg b.i.d.76.775.575.5
NVA237 25.0 µg q.d.43.842.042.0
NVA237 50.0 µg b.i.d.86.285.485.4
NVA237 50.0 µg q.d.60.158.558.5

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Percentage of the Maximal Response of NVA237 Doses on Trough Forced Vital Capacity on Days 1, 7 and 14

"Percentage of the maximal response of NVA237 Doses on Trough Forced Vital Capacity (FVC) on Days 1, 7 and 14. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. Trough FVC was assessed via spirometry. (see Outcome Measure #33).~Trough FVC is defined as the mean of the FVC values measured at 23 hours 15 mins and 23 hours 45 mins post-dose." (NCT01119950)
Timeframe: Days 1, 7 and 14

,,,,,,
InterventionPercentage of maximal response (Mean)
Day 1 (n=88, 92, 91, 90, 94, 94, 87)Day 7 (n=87, 92, 90, 91, 95, 93, 85, 87)Day 14 (n= 85, 90, 91, 88, 94, 93, 81, 84)
NVA237 100.0 µg q.d.69.169.769.7
NVA237 12.5 µg b.i.d.52.953.653.6
NVA237 12.5 µg q.d.22.823.323.3
NVA237 25.0 µg b.i.d.68.769.369.3
NVA237 25.0 µg q.d.36.837.437.4
NVA237 50.0 µg b.i.d.81.081.481.4
NVA237 50.0 µg q.d.53.454.054.0

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Trough Forced Expiratory Volume in One Second at Days 1, 7 and 14

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~Trough FEV1 was measured on Days 1, 7 and 14 of treatment. Trough FEV1 was defined as the mean of the FEV1 values measured at 23 hours 15 mins and 23 hours 45 mins post-dose." (NCT01119950)
Timeframe: 23 hours 15 mins and 23 hours 45 mins post-dose on Days 1, 7 and 14

,,,,,,,
InterventionLiters (Mean)
Day 1 (n= 88,92,91, 90, 94, 94, 87, 86)Day 7 (n= 87,92,90, 91, 95, 93, 85, 87)Day 14 (n= 85,90,91, 88, 94, 93, 81, 84)
NVA237 100.0 µg q.d.1.3671.3721.375
NVA237 12.5 µg b.i.d.1.3751.3491.335
NVA237 12.5 µg q.d.1.2991.3321.336
NVA237 25.0 µg b.i.d.1.3551.3751.359
NVA237 25.0 µg q.d.1.3871.4221.349
NVA237 50.0 µg b.i.d.1.4921.4801.500
NVA237 50.0 µg q.d.1.3711.3911.356
Placebo1.2901.2941.284

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Forced Expiratory Volume in One Second AUC 0-24 Hours for Once and Twice Daily Regimens of NVA237 for the Same Total Daily Dose of NVA237, After 28 Days of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~The Area Under the Curve (AUC) 0-24 hours FEV1 between dosing regimens over the range 20 micrograms to 55 micrograms total daily dose at -25 min,-15 min (predose); 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28.~AUC 0-24 hours FEV1 was measured in response to all doses administered (12.5 µg q.d., 25.0 µg q.d., 12.5 µg b.i.d., 50 µg q.d., 25 µg b.i.d., 100 µg q.d., 50.0 µg b.i.d., and Placebo; see Outcome Measure # 20), and was used to compute modeled dose-response curves for once-daily and twice-daily regimens separately. The difference between those curves was computed at pre-specified theoretical doses (20 µg, 25 µg, 30 µg, 35 µg, 40 µg, 45 µg, 50 µg, and 55 µg) chosen at points likely to show the largest differences between the once-daily and twice-daily regimens." (NCT01119950)
Timeframe: -25 min,-15 min (predose); 5 min,15 min, 1,2,3,4,6,8,10 hours, 11 hours 55min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28

InterventionLiters (Mean)
Total daily dose 20 ugTotal daily dose 25 ugTotal daily dose 30 ugTotal daily dose 35 ugTotal daily dose 40 ugTotal daily dose 45 ugTotal daily dose 50 ugTotal daily dose 55 ug
Overall Study0.0080.0080.0080.0080.0080.0080.0080.007

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Trough Forced Expiratory Volume in One Second for Once and Twice Daily Regimens of NVA237 for the Same Total Daily Dose of NVA237

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer.~FEV1 was measured between dosing regimens (over the range 20 micrograms to 55 micrograms total daily dose) after 28 days of treatment.~Mean trough FEV1 was measured in response to all doses administered (12.5 µg q.d., 25.0 µg q.d., 12.5 µg b.i.d., 50 µg q.d., 25 µg b.i.d., 100 µg q.d., 50.0 µg b.i.d., and Placebo; see Outcome Measure # 19), and was used to compute modeled dose-response curves for once-daily and twice-daily regimens separately. The difference between those curves was computed at pre-specified theoretical doses (20 µg, 25 µg, 30 µg, 35 µg, 40 µg, 45 µg, 50 µg, and 55 µg) chosen at points likely to show the largest differences between the once-daily and twice-daily regimens. The theoretical responses to each dosing schedule separately and the difference between the once-daily and twice-daily regimens are represented below." (NCT01119950)
Timeframe: day 28

InterventionLiters (Mean)
Total daily dose 20 ugTotal daily dose 25 ugTotal daily dose 30 ugTotal daily dose 35 ugTotal daily dose 40 ugTotal daily dose 45 ugTotal daily dose 50 ugTotal daily dose 55 ug
Overall Study0.0370.0370.0360.0350.0340.0330.0320.031

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Peak Forced Expiratory Volume in One Second at Day 28 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~Peak FEV1 is the maximum FEV1 recorded in a pre-determined period of time. Measurements were taken at 25 min , 15 min pre-dose, 5 min, 15 min, 1 , 2 ,3 , 4 , 6 , 8 , 10 hours , 11 hour 55 min and 14 hour post-dose on day 28." (NCT01119950)
Timeframe: 25 min , 15 min pre-dose, 5 min, 15 min, 1 , 2 ,3 , 4 , 6 , 8 , 10 hours , 11 hour 55 min and 14 hour post-dose on day 28

InterventionLiters (Mean)
NVA237 12.5 µg q.d.1.500
NVA237 25.0 µg q.d.1.563
NVA237 12.5 µg b.i.d.1.494
NVA237 50.0 µg q.d.1.514
NVA237 25.0 µg b.i.d.1.504
NVA237 100.0 µg q.d.1.570
NVA237 50.0 µg b.i.d.1.630
Placebo1.397

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Forced Expiratory Volume in One Second Area Under the Curve 0-24 Hours at Day 28 of Treatment

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards.~FEV1 Area Under the Curve (AUC) measurements were taken at 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28. FEV1 AUC was calculated as the sum of trapezoids divided by the length of time." (NCT01119950)
Timeframe: 5 min, 15 min, 1,2,3,4,6,8,10 hours, 11 hours 55 min, 14,20,22 hours; 23 hours 15 min, 23 hours 45 min (postdose) on day 28

InterventionLiters (Mean)
NVA237 12.5 µg q.d.1.307
NVA237 25.0 µg q.d.1.351
NVA237 12.5 µg b.i.d.1.321
NVA237 50.0 µg q.d.1.317
NVA237 25.0 µg b.i.d.1.339
NVA237 100.0 µg q.d.1.395
NVA237 50.0 µg b.i.d.1.457
Placebo1.247

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Forced Expiratory Volume in One Second at 12 Hours on Day 28 of Treatment

Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Spirometry was performed according to internationally accepted standards. (NCT01119950)
Timeframe: 12 hours on day 28

InterventionLiters (Mean)
NVA237 12.5 µg q.d.1.272
NVA237 25.0 µg q.d.1.330
NVA237 12.5 µg b.i.d.1.279
NVA237 50.0 µg q.d.1.330
NVA237 25.0 µg b.i.d.1.320
NVA237 100.0 µg q.d.1.391
NVA237 50.0 µg b.i.d.1.429
Placebo1.256

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Maximal Response of Incremental Once Daily and Twice Daily Doses of NVA237 That Each Dose Achieves in Relation to the Maximal Effect of NVA237 on Trough Forced Expiratory Volume in One Second at Day 28

"Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. The maximal response of incremental once daily and twice daily doses of NVA237 that each dose achieves in relation to the maximal effect of NVA237 on Trough FEV1 was measured at Day 28. FEV1 was measured in response to all doses administered (see Outcome Measure #19).~All trough FEV1 responses to active doses were corrected using the placebo response. A modeled dose response curve was fit to the placebo-corrected data, and extrapolated to estimate the maximal response. All trough FEV1 data are reported as a percentage of the theoretical maximal response.~Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values." (NCT01119950)
Timeframe: Day 28

InterventionPercentage of maximal response (Mean)
NVA237 12.5 µg q.d.27.1
NVA237 25.0 µg q.d.42.0
NVA237 12.5 µg b.i.d.61.6
NVA237 50.0 µg q.d.58.5
NVA237 25.0 µg b.i.d.75.5
NVA237 100.0 µg q.d.73.0
NVA237 50.0 µg b.i.d.85.4

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Rate of Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in QVA149 and Open-label Tiotropium Treatment Arms During the Treatment Period.

"A Chronic Obstructive Pulmonary Disease (COPD) exacerbation was defined as a worsening of two or more of the following major symptoms for at least 2 consecutive days: dyspnea, sputum volume or sputum purulence OR a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: sore throat, colds (nasal discharge and/or nasal congestion), fever without other cause, cough or wheezing. A COPD exacerbation was considered of moderate severity if treatment with systemic glucocorticosteroids or antibiotics or both was required and severe if hospitalization was required. An emergency room (ER) visit of longer than 24 hours was considered a hospitalization.~Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years" (NCT01120691)
Timeframe: 76 weeks

InterventionExacerbations per year (Number)
QVA1490.94
Open-label Tiotropium1.06

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Number of Days With Moderate or Severe Exacerbation That Required Treatment With Systemic Corticosteroids and Antibiotics

The number of exacerbation days is defined as the sum of the duration of days recorded as an exacerbation for all exacerbations recorded per patient. (NCT01120691)
Timeframe: 64 weeks

,,
InterventionDays (Mean)
systemic corticosteroids [n= 97, 108, 109]antibiotics [n= 195, 177, 177]corticosteroids and antibiotic [n= 266, 290, 270]
NVA23725.2218.1026.18
Open-label Tiotropium17.5725.9422.03
QVA14920.4925.0822.10

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Cumulative Rates of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations for Multiple COPD Exacerbation at Different Time Points

Cumulative rates were estimated using Anderson and Gill method. Chronic Obstructive Pulmonary Disease (COPD) exacerbations are considered to be moderate if treatment with systemic corticosteroids and/or antibiotics was required. COPD exacerbations are considered to be severe if treatment for moderate severity and hospitalization were required. Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years (NCT01120691)
Timeframe: 26, 52, 64, 76 weeks

,,
Interventionexacerbations per year (Number)
26 weeks52 weeks64 weeks76 weeks
NVA2370.651.131.361.59
Open-label Tiotropium0.631.111.311.55
QVA1490.570.991.191.39

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Change in Mean Daily Use (Number of Puffs) of Rescue Therapy Between QVA149, NVA237 and Open Label Tiotropium From Baseling Over the 64 Week Treatment Period

The severe or less FEV1 % predicted (post bronchodilator)>=30%; very severe=> FEV1 % predicted(the post bronchodilator)<30%.Number of puffs of rescue medication taken in the previous 12 hours was recorded in patient diary in the morning and in the evening for 26 weeks.The total number of puffs per day was calculated and divided by the number of days with data to determine the mean daily number of puffs of rescue medication for each patient.Rescue medication data recorded during the 14 day run-in was used to calculate the baseline.A negative change from baseline indicates improvement. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. (NCT01120691)
Timeframe: Baseline (14 day run-in), 64 weeks

,,
Intervention# puffs (Least Squares Mean)
Mean Daily # puffs Severe or Less(n=565,575,561)Mean Daily # puffs Very Severe (n=143,149,148)
NVA237-1.5-1.1
Open-label Tiotropium-1.6-1.0
QVA149-2.3-2.1

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Time to Study Withdrawal or Premature Discontinuation for Any Reason Between QVA149 (110/50 µg q.d.), NVA237 (50 µg q.d.) and Open Label Tiotropium (18 µg q.d.) During the Treatment Period.

Time to Study Withdrawal or Premature Discontinuation for Any Reason was analyzed for each treatment group using a Kaplan-Meier estimation for the modified safety set. Patients who did not discontinue early were censored at the final visit of the treatment phase. (NCT01120691)
Timeframe: 64 weeks

Interventiondays (Median)
QVA149NA
NVA237NA
Open-label TiotropiumNA

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Time to First Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbation Between QVA149, NVA237 and Open Label Tiotropium During the Treatment Period

"A Chronic Obstructive Pulmonary Disease (COPD) exacerbation was defined as a worsening of two or more of the following major symptoms for at least 2 consecutive days: dyspnea, sputum volume or sputum purulence OR a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: sore throat, colds (nasal discharge and/or nasal congestion), fever without other cause, cough or wheezing. A COPD exacerbation was considered of moderate severity if treatment with systemic glucocorticosteroids or antibiotics or both was required and severe if hospitalization was required. An emergency room (ER) visit of longer than 24 hours was considered a hospitalization.~Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years" (NCT01120691)
Timeframe: 64 weeks

Interventiondays (Median)
QVA149296
NVA237287
Open-label Tiotropium331

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Rate of Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations in QVA149 and NVA237 Treatment Arms During the Treatment Period.

"A Chronic Obstructive Pulmonary Disease (COPD) exacerbation was defined as a worsening of two or more of the following major symptoms for at least 2 consecutive days: dyspnea, sputum volume or sputum purulence OR a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: sore throat, colds (nasal discharge and/or nasal congestion), fever without other cause, cough or wheezing. A COPD exacerbation was considered of moderate severity if treatment with systemic glucocorticosteroids or antibiotics or both was required and severe if hospitalization was required. An emergency room (ER) visit of longer than 24 hours was considered a hospitalization.~Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years" (NCT01120691)
Timeframe: 64 weeks

InterventionExacerbations per year (Number)
QVA1490.94
NVA2371.07

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Rate of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations Requiring the Use of Both Systemic Glucocorticosteroids and Antibiotics

Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years (NCT01120691)
Timeframe: 64 weeks

Interventionexacerbations per year (Number)
QVA1490.46
NVA2370.58
Open-label Tiotropium0.54

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Percentage of Patients With Study Withdrawal or Premature Discontinuation for Any Reason Between QVA149 (110/50 µg q.d.), NVA237 (50 µg q.d.) and Open Label Tiotropium (18 µg q.d.)During the Treatment Period

Percentage of Patients With Study Withdrawal or Premature Discontinuation for Any Reason was analyzed for each treatment group using a Kaplan-Meier estimation for the modified safety set. Patients who did not discontinue early were censored at the final visit of the treatment phase. (NCT01120691)
Timeframe: 64 weeks

Interventionpercentage of participants (Number)
QVA14921.8
NVA23727.3
Open-label Tiotropium24.2

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Change From Baseline of Percentage of Days Without Rescue Therapy Use Between QVA149,NVA237 and Open Label Tiotropium Over the 64 Week Treatment Period

A day with no rescue medication use is defined from the diary data as any day where the patient recorded no rescue medicine use during the previous 12 hours. The percentage of days is calculated by the number of days with no rescue medicine use/total number of days with evaluable data X 100. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01120691)
Timeframe: Baseline (14 day run-in), 64 weeks

Interventionpercentage of days (Least Squares Mean)
QVA14929.36
NVA23721.65
Open-label Tiotropium23.86

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Pre-dose Forced Expiratory Volume in 1 Second (FEV-1) After 4, 12, 26, 38, 52 and 64 Weeks of Treatment Between QVA149, NVA237 and Open Label Tiotropium

"Pulmonary function assessments were performed using centralized spirometry. The spirometer was customized and programmed according to the requirements of the study protocol in accordance with American Thoracic Society (ATS) standards.~Spirometry measurements taken were FEV1 at -45 minutes and -15 minutes pre-dose. Three acceptable maneuvers had to be performed for each time point. The FEV1 values recorded had to be the highest values measured irrespective of whether or not they occurred on the same curve.~The mixed model for analysis contained treatment as a fixed effect with average of the 45 minutes and 15 minutes pre dose FEV1 measurements at day 1 as the baseline measurement, FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at -14 Day) as covariates." (NCT01120691)
Timeframe: 4, 12, 26, 38, 52 and 64 weeks

,,
InterventionL (liters) (Least Squares Mean)
predose FEV1 Week 4 (n= 656,654,630)predose FEV1 Week 12 (n= 666,663,653)predose FEV1 Week 26 (n= 604,577,599)predose FEV1 Week 38 (n= 593,549,583)predose FEV1 Week 52 (n= 557,538,548)predose FEV1 Week 64 (n= 549,504,530)
NVA2370.991.010.991.000.980.98
Open-label Tiotropium1.001.011.001.000.990.99
QVA1491.081.081.071.081.051.05

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Pre-dose Forced Vital Capacity (FVC)After 4, 12, 26, 38, 52 and 64 Weeks of Treatment Between QVA149, NVA237 and Open Label Tiotropium

"Pulmonary function assessments were performed using centralized spirometry. The spirometer was customized and programmed according to the requirements of the study protocol in accordance with American Thoracic Society (ATS) standards.~Pre-dose Forced Vital Capacity (FVC) is defined as the average of the -15 minutes and the -45 minutes FVC values. Baseline is defined as the average of the -45 minutes and -15 minutes FVC values taken on day 1 prior to first dose. FVC data taken within 6h of rescue medication or within 7 days of systemic corticosteroid is excluded from this analysis" (NCT01120691)
Timeframe: 4, 12, 26, 38, 52 and 64 weeks

,,
InterventionL (liters) (Least Squares Mean)
predose FVC Week 4 (n= 656,654,630)predose FVC Week 12 (n= 623,621,619)predose FVC Week 26 (n= 604,577,599)predose FVC Week 38 (n= 592,548,580)predose FVC Week 52 (n= 557,538,547)predose FVC Week 64 (n= 549,502,526)
NVA2372.592.632.602.652.582.57
Open-label Tiotropium2.602.652.612.632.582.59
QVA1492.742.772.732.762.682.67

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St. George's Respiratory Questionnaire (SGRQ) Scores Between QVA149, NVA237 and Open Label Tiotropium Over 12, 26, 38, 52 and 64 Weeks of Treatment

St. George's Respiratory Questionnaire (SGRQ) is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity, and impacts. The lowest possible value is zero and the highest 100. Higher values correspond to greater impairment in quality of life. Mixed model used baseline SGRQ, baseline inhaled corticosteroid (ICS) use, Forced Expiratory Volume in 1 Second (FEV1) prior to inhalation of short acting beta-agonist (SABA), and FEV1 45 minutes post-inhalation of SABA as covariates. SGRQ total score is the sum of the scores from the three components; symptoms, activity and impacts. (NCT01120691)
Timeframe: 12, 26, 38, 52 and 64 weeks

,,
Interventionunits on a scale (Least Squares Mean)
Week 12 (n= 694,694,676)Week 26 (n= 684,677,658)Week 38 (n= 648,626,635)Week 52 (n= 625,593,613)Week 64 (n= 600,564,579)
NVA23747.1345.9345.5345.9645.46
Open-label Tiotropium47.6245.7745.8646.2146.08
QVA14944.6944.0642.7243.3843.39

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Exercise Endurance Time During a Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks (Day 21) of Treatment

SMETT is an exercise procedure where the patient cycles at 80% of the maximum workload (Wmax )value achieved at the Incremental exercise test. During this test, the patient will cycle at a constant load. Exercise endurance time was from commencement of loaded pedaling to stopping exercise. The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect. (NCT01154127)
Timeframe: Day 21

Interventionseconds (Least Squares Mean)
NVA237505.63
Placebo416.70

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Specific Airways Conductance (SGaw)

"SGaw is a measure of how hard it is to get air into the lungs, measured by (Sec(-1)*kP). Whole body plethysmography (Bodybox) was used to measure SGaw.~The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 21

,
Interventionlitres/(Second*kpa); kpa = kilopascal (Least Squares Mean)
SGaw at trough, Day 21 (n= 98, 96)SGaw at peak, Day 21 (n= 97, 96)
NVA2370.480.66
Placebo0.400.42

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Slow Vital Capacity (SVC) and Total Lung Capacity (TLC)

"Vital Capacity is the amount of air that can be forcibly exhaled from the lungs after a full inhalation. Slow Vital Capacity (SVC) test is performed by having the patient slowly and completely blow out all of the air from their lungs.~Total Lung Capacity (TLC) is the best vital capacity plus residual volume. Whole body plethysmography (Bodybox) was used to measure SVC and TLC. The trough effects of Day 1 treatment are derived from values prior to morning dosing on the next treatment day (Day 2 of the corresponding period)." (NCT01154127)
Timeframe: Day 21

,
InterventionLitres (Least Squares Mean)
SVC at trough, Day 21 (n= 98, 96)SVC at peak, Day 21 (n= 97, 96)TLC at trough, Day 21 (n= 98, 96)TLC at peak, Day 21 (n= 97, 96)
NVA2373.213.406.996.86
Placebo3.143.147.177.10

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Peak and Trough (24 h Post Dose) Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC)

"FEV1 is the amount of air that can be exhaled in one second. FEV1 was measured with spirometry conducted according to internationally accepted standards.~FVC is the volume of air that can forcibly be blown out after full inspiration and is used in spirometry tests.~The trough effects of Day 1 treatment are derived from values prior to morning dosing on the next treatment day (Day 2 of the corresponding period).~The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 21

,
InterventionLitres (Least Squares Mean)
FEV1 at peak, Day 21FEV1 at trough, Day 21FVC at peak, Day 21FVC at trough, Day 21
NVA2371.601.443.373.17
Placebo1.351.333.002.96

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Inspiratory Capacity (IC) at Rest (1 Hour Post Dose) and at Peak (End of Exercise) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks of Treatment

"IC at peak was observed using spirometry. However, two different methodologies (whole body plethysmography (Bodybox) and spirometry) were used to observe IC at rest.~The analysis of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 21

,
InterventionLitres (Least Squares Mean)
IC at peak (Spirometry), Day 21 (n = 93, 90)IC at rest (Bodybox) Day 21 (n= 97, 96)IC at rest (Spirometry), Day 21 (n= 98, 96)
NVA2372.222.492.39
Placebo2.032.262.17

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Leg Discomfort (Borg CR10 Scale) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks Treatment

"The modified Borg CR10 Scale consists of 12-point score that the patients pointed to so as to indicate their level of leg discomfort before and during exercise testing (where 0 indicates no breathlessness at all and 12 indicates maximum breathlessness).~A reduction in this score indicates an improvement. The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 21

Interventionunits on a scale (Least Squares Mean)
NVA2376.21
Placebo7.05

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Exertional Dyspnea (Borg CR10 Scale) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks Treatment

"The Borg CR10 Scale consists of 12-point score that the patients pointed to so as to indicate their level of dyspnea before and during exercise testing (where 0 indicates no breathlessness at all and 12 indicates maximum breathlessness).~A reduction in this score indicates an improvement. The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 21

Interventionunits on a scale (Least Squares Mean)
NVA2375.64
Placebo6.80

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Exercise Endurance Time During a Sub-maximal Constant-load Cycle Ergometry Test (SMETT) on Treatment Day 1

"SMETT is an exercise procedure where the patient cycles at 80% of the maximum workload (Wmax )value achieved at the Incremental exercise test. During this test, the patient will cycle at a constant load. Exercise endurance time was from commencement of loaded pedaling to stopping exercise.~The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect." (NCT01154127)
Timeframe: Day 1

InterventionSeconds (Least Squares Mean)
NVA237490.92
Placebo447.78

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Isotime Inspiratory Capacity (IC) During Sub-maximal Constant-load Cycle Ergometry Test (SMETT) After 3 Weeks of Treatment

Isotime is the last matching timepoint in the submaximal exercise tolerance test (SMETT) at which for both periods the patient has a test result. The analysis-of covariance model included the sequence, period, and treatment as fixed factors, the baseline value as covariate and the patient as a random effect. (NCT01154127)
Timeframe: Day 21

InterventionLiters (Least Squares Mean)
NVA2372.22
Placebo2.02

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Monitoring of Adverse Events During Study Administration

Subjects will be monitored for episodes of apnea, laryngospasm, vomiting, oxygen desaturation(<92%), and changes in heart rate and blood pressure. The time frame will include the time the study medication is administered until at least 30 minutes post Ketamine administration. (NCT01191398)
Timeframe: 1 hour

Interventionadverse events (Number)
Placebo1
Atropine0
Glycopyrrolate0

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Difference in Salivary Flow Rate (ml/Min) Between Study Groups

Oral Secretions will be collected by oral suctioning starting at the time Ketamine is administed until 30 minutes post Ketamine administration. Suctionings will be done by trained personnel every 5 minutes starting with the Ketamine administration. Flow rate will be calculated by dividing the total volume of saliva suctioned by the total time suctioned (30 minutes) (NCT01191398)
Timeframe: 30 minutes

Interventionml/min (Mean)
Placebo.072
Atropine.003
GlycopyrrolateNA

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Time From Potent Inhaled Anesthetic Discontinuation to First Response to Command (T1)

"At the conclusion of surgery, after the patient's potent inhaled anesthetic was discontinued, the commands open your eyes and squeeze my hand were given at 30-second intervals. The time at which patient first appropriately response to both commands was noted as T1." (NCT01199237)
Timeframe: Up to 1 hour post-operative

Interventionseconds (Mean)
Sevoflurane623
Desflurane343

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Recovery of Ability to Swallow After Neostigmine/Glycopyrrolate Antagonism of Rocuronium Paralysis.

The patient is judged by the primary anesthetist to be awake at time T1. At 2 minutes after T1, the patient was asked to swallow 20mL of water from a paper cup, and a blinded observer judged the ability to swallow based on transit of water to the posterior pharynx (absence of pooling or drooling) and absence of cough or gag. (NCT01199237)
Timeframe: At 2 minutes after response to command (T1).

,
Interventionparticipants (Number)
able to swallow at T1+2 minutesunable to swallow at T1+2 minutes
Desflurane256
Sevoflurane1610

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Time From Anesthetic Discontinuation to First Ability to Swallow

At 2 minutes after first response to command (T1), the patient was asked to swallow 20 mL of water from a paper cup, and an observer blinded to anesthetic assignment assessed the ability to swallow based on transit of water to the posterior pharynx (absence of pooling or drooling) and absence of cough or gag (indicating misdirection of the water bolus into the laryngeal inlet). This test was repeated at 6, 14, 22, 30 and 60 minutes after the time of first response to command. (NCT01199237)
Timeframe: up to 60 minutes after T1

InterventionSeconds (Mean)
Sevoflurane1275
Desflurane718

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Nausea and Vomiting

Patients were asked to rate their experience of nausea and vomiting on a 0-10 verbal analog scale, with 0 being absence and 10 being the worst imaginable (NCT01199237)
Timeframe: 30 minutes after T1

,
Interventionunits on a scale (Mean)
NauseaVomiting
Desflurane1.3590
Sevoflurane0.3850

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Nausea and Vomiting

Patients were asked to rate their experience of nausea and vomiting on a 0-10 verbal analog scale, with 0 being absence and 10 being the worst imaginable (NCT01199237)
Timeframe: 60 minutes after T1

,
Interventionunits on a scale (Mean)
NauseaVomiting
Desflurane1.3330.026
Sevoflurane0.2630

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Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 4 Hours at Day 1 and Week 26

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; and 1, 2, and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: From 5 minutes to 4 hours post-dose Day 1 and Week 26

,,,,
InterventionLiters (Least Squares Mean)
Day 1Week 26 (n=433,418,412,435,186)
Glycopyrronium (NVA237)1.491.43
Indacaterol (QAB149)1.461.46
Indacaterol and Glycopyrronium (QVA149)1.521.57
Placebo1.301.23
Tiotropium1.441.44

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"Percentage of Days Able to Perform Usual Daily Activities Over 26 Weeks"

"Patients answered the question Did your respiratory symptoms stop you performing your usual activities today?-Not at all in their daily diary. The percentage of days is calculated by the number of days patient is able to perform daily activities/total number of days with evaluable data X 100. A mixed model was used with treatment as a fixed effect with baseline Percent of Days and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect." (NCT01202188)
Timeframe: 26 Weeks

InterventionPercentage of days (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)45.97
Indacaterol (QAB149)40.94
Glycopyrronium (NVA237)40.10
Tiotropium37.52
Placebo34.49

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Transitional Dyspnea Index (TDI) Focal Score at Week 26

A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing). TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort. Each domain is scored from -3 (major deterioration) to 3 (major improvement) to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. A mixed model was used with treatment as a fixed effect with Baseline Dyspnea Index Score and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: Week 26

InterventionScore on a scale (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)2.72
Placebo1.63

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Percentage of Patients With at Least One Moderate or Severe COPD Exacerbation Over the 26 Week Treatment Period

(NCT01202188)
Timeframe: 26 Weeks

InterventionPercentage of participants (Number)
Indacaterol and Glycopyrronium (QVA149)17.9
Indacaterol (QAB149)21.6
Glycopyrronium (NVA237)18.8
Tiotropium17.7
Placebo25.8

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Baseline Transitional Dyspnea Index (BDI/TDI) Focal Score at Week 12 and Week 26

"A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing). BDI/TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. BDI was measured at day 1 prior to the first dose with domain scores ranging from 0=very severe to 4=no impairment and a total score ranging from 0 to 12(best). TDI captures changes from baseline. Each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score.~A mixed model was used with treatment as a fixed effect with Baseline Dyspnea Index Score and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators as covariates and included baseline smoking status, baseline inhaled corticosteroids and region as fixed effects with center nested within region as a random effect." (NCT01202188)
Timeframe: Baseline, Week 12, Week 26

,,,,
InterventionScore on a scale (Least Squares Mean)
BDI_ baseline for Week 12TDI Week 12BDI_baseline for Week 26 (n=439,440,424,441,193)TDI Week 26 (n=439,440,424,441,193)
Glycopyrronium (NVA237)6.212.046.222.52
Indacaterol (QAB149)6.282.186.282.47
Indacaterol and Glycopyrronium (QVA149)6.452.446.452.72
Placebo6.531.226.561.63
Tiotropium6.431.816.462.21

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Change From Baseline (BL) in the Daytime and Night Time Rescue Medication Use (Number of Puffs) Over 26 Weeks

The number of puffs of rescue medication taken in the previous 12 hours was record in patient diary in the morning and in the evening for 26 weeks. The total number of puffs in the morning and evening were calculated and divided by the number of days with data to determine the mean daily number of daytime and nighttime puffs. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline (BL) ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: Baseline, Week 26

,,,,
InterventionPuffs (Least Squares Mean)
Daytime Change from BL (n=415,410,395,418,195)Nighttime Change from BL (n=418,413,399,422,198)
Glycopyrronium (NVA237)-0.75-0.48
Indacaterol (QAB149)-0.96-0.63
Indacaterol and Glycopyrronium (QVA149)-1.11-0.78
Placebo-0.58-0.34
Tiotropium-0.83-0.52

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Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication at Week 12 and Week 26

The number of puffs of rescue medication taken in the previous 12 hours was record in patient diary in the morning and in the evening for 26 weeks. The total number of puffs per day was calculated and divided by the number of days with data to determine the mean daily number of puffs of rescue medication for each patient. Rescue medication data recorded during the 14 day run-in was used to calculate the baseline. A negative change from baseline indicates improvement. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: Baseline, Week 12, Week 26

,,,,
InterventionPuffs per day (Least Squares Mean)
Change from Baseline (BL) at Week 12Change from BL at Week 26 (n=419,416,403,424,199)
Glycopyrronium (NVA237)-1.22-1.22
Indacaterol (QAB149)-1.46-1.57
Indacaterol and Glycopyrronium (QVA149)-1.82-1.88
Placebo-0.83-0.92
Tiotropium-1.28-1.34

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Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment

Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 23 hours 15 minutes and 23 hour 45 minute post-dose Week 26

InterventionLiters (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)1.45
Indacaterol (QAB149)1.38
Glycopyrronium (NVA237)1.36

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Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment With QVA149 Compared to Tiotropium

Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 23 hours 15 minutes and 23 hour 45 minute post-dose Week 26

InterventionLiters (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)1.46
Tiotropium1.39

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Percentage of Participants With COPD Exacerbations Requiring Hospitalization or Treatment With Systemic Corticosteroids and/or Antibiotics But no Hospitalization

(NCT01202188)
Timeframe: 26 Weeks

,,,,
InterventionPercentage of participants (Number)
Requiring hospitalizationCorticosteroids_Antibiotics-No hospitalization
Glycopyrronium (NVA237)1.917.8
Indacaterol (QAB149)2.519.7
Indacaterol and Glycopyrronium (QVA149)2.116.7
Placebo3.023.3
Tiotropium1.016.9

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Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 23 Hours 45 Minutes at Week 26

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; and 1, 2, 4, 8, 12, 23 hours 15 minutes and 23 hours 45 minutes post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: From 5 minutes to 23 hours 45 minutes post-dose Week 26

InterventionLiters (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)1.46
Indacaterol (QAB149)1.35
Glycopyrronium (NVA237)1.35
Tiotropium1.36
Placebo1.15

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St. George's Respiratory Questionnaire (SGRQ) Total Score at Week 26

SGRQ is a health related quality of life questionnaire consisting of 51 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. A mixed model was used with treatment as a fixed effect with Baseline SGRQ and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 26 weeks

InterventionScore on a scale (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)37.01
Placebo40.02

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Rate of Moderate or Severe COPD Exacerbation

Rate of moderate or severe exacerbations per year = total number of moderate or severe exacerbations / total number of treatment years (NCT01202188)
Timeframe: 26 Weeks

InterventionExacerbations per year (Number)
Indacaterol and Glycopyrronium (QVA149)0.46
Indacaterol (QAB149)0.59
Glycopyrronium (NVA237)0.52
Tiotropium0.45
Placebo0.75

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Percentage of Patients With a Clinically Important Improvement of at Least 1 Point in TDI Focal Score After 26 Weeks of Treatment

A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing) at Week 12 and Week 26. TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort. The BDI (baseline) was measured at Day 1. The TDI captures changes from baseline. Each domain is scored from -3 (major deterioration) to 3 (major improvement) to give an overall TDI focal score of -9 to 9. (NCT01202188)
Timeframe: Baseline, Week 26

InterventionPercentage of participants (Number)
Indacaterol and Glycopyrronium (QVA149)68.1
Indacaterol (QAB149)64.6
Glycopyrronium (NVA237)63.7
Tiotropium59.2
Placebo57.5

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Trough Forced Expiratory Volume In One Second (FEV1) After 26 Weeks of Treatment With QVA149, QAB149 and NVA237 Compared to Placebo

Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the mean of the 23 hour 15 minute and 23 hour 45 minute post-dose values. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 23 hours 15 minutes and 23 hour 45 minute post-dose Week 26

InterventionLiters (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)1.45
Indacaterol (QAB149)1.38
Glycopyrronium (NVA237)1.36
Placebo1.25

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Percentage of Patients With a Clinically Important Improvement From Baseline of at Least 4 Units in the SGRQ Total Score After 26 Weeks of Treatment

SGRQ is a health related quality of life questionnaire consisting of 51 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. (NCT01202188)
Timeframe: Baseline, Week 26

InterventionPercentage of participants (Number)
Indacaterol and Glycopyrronium (QVA149)63.7
Indacaterol (QAB149)63.0
Glycopyrronium (NVA237)60.5
Tiotropium56.4
Placebo56.6

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24 Hour Holter Monitoring in a Subset of Patients

"24-hourly mean heart rate was performed using a Holter Monitor at Weeks 12 and 26 in a subgroup of patients. Mixed model: heart rate = treatment + baseline heart rate + baseline smoking status + baseline ICS use + region + center (region) + error. Center was included as a random effect nested within region.~The 24-hourly mean heart rate is the mean heart rate over the 24 hour period, derived using hourly mean heart rate beats per minute." (NCT01202188)
Timeframe: Week 12, Week 26

,,,
Interventionbeats per minute (Least Squares Mean)
Week 12 (n=35,38,27,15)Week 26 (n=36,36,26,16)
Glycopyrronium (NVA237)79.480.5
Indacaterol (QAB149)79.978.6
Indacaterol and Glycopyrronium (QVA149)80.879.8
Placebo78.977.0

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Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Over 26 Weeks

The number of puffs of rescue medication taken in the previous 12 hours was record in patient diary in the morning and in the evening for 26 weeks. The total number of puffs per day was calculated and divided by the number of days with data to determine the mean daily number of puffs of rescue medication for each patient. Rescue medication data recorded during the 14 day run-in was used to calculate the baseline. A negative change from baseline indicates improvement. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: Baseline, Week 26

InterventionPuffs per day (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)-1.88
Placebo-0.92

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"Percentage of Nights With No Night Time Awakenings Over 26 Weeks"

A day with no night time awakenings is defined from the diary data as any day where the patient did not wake up due to COPD symptoms. The percentage of nights is calculated by the number of days with no nighttime awakenings/total number of days with evaluable data X 100. A mixed model was used with treatment as a fixed effect with baseline Percent days and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 26 Weeks

InterventionPercentage of nights (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)63.68
Indacaterol (QAB149)62.48
Glycopyrronium (NVA237)58.64
Tiotropium60.00
Placebo53.67

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"Percentage of Days With no Rescue Medication Use Over 26 Weeks"

A day with no rescue medication use is defined from the diary data as any day where the patient recorded no rescue medicine use during the previous 12 hours. The percentage of days is calculated by the number of days with no rescue medicine use/total number of days with evaluable data X 100. A mixed model was used with treatment as a fixed effect with baseline number of puffs and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 26 Weeks

InterventionPercentage of days (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)47.09
Indacaterol (QAB149)44.81
Glycopyrronium (NVA237)37.74
Tiotropium36.51
Placebo34.76

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"Percentage of Days With No Daytime Symptoms Over 26 Weeks"

A day with no day time symptoms is defined from the diary data as any day where the patient recorded no coughing, no wheezing, no sputum production and no breathlessness during the previous 12 hours (approximately 8AM to 8PM). The percentage of days is calculated by the number of days with no daytime symptoms/total number of days with evaluable data X 100. A mixed model was used with treatment as a fixed effect with baseline Percent of days and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: 26 Weeks

InterventionPercentage of days (Least Squares Mean)
Indacaterol and Glycopyrronium (QVA149)7.49
Indacaterol (QAB149)9.17
Glycopyrronium (NVA237)6.40
Tiotropium5.54
Placebo4.44

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Standardized FEV1 (With Respect to Length of Time) Area Under the Curve (AUC) From 5 Minutes to 12 Hours at Day 1 and Week 26

FEV1 was measured with spirometry conducted according to internationally accepted standards. Measurements were made at 5, 15, and 30 minutes; and 1, 2, 4, 8, 12 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. A mixed model was used with treatment as a fixed effect with baseline FEV1 and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: From 5 minutes to 12 hours post-dose Day 1 and Week 26

,,,,
InterventionLiters (Least Squares Mean)
Day1Week 26 (n=60,55,58,67,27)
Glycopyrronium (NVA237)1.421.39
Indacaterol (QAB149)1.401.39
Indacaterol and Glycopyrronium (QVA149)1.501.52
Placebo1.241.18
Tiotropium1.381.39

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St. George's Respiratory Questionnaire (SGRQ) Total Score After 12 and 26 Weeks of Treatment

SGRQ is a health related quality of life questionnaire consisting of 51 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. A mixed model was used with treatment as a fixed effect with Baseline SGRQ and FEV1 prior to inhalation and FEV1 60 minutes post inhalation of two short acting bronchodilators (components of reversibility at Day -14) as covariates. The model also included baseline smoking status (current/ex-smoker), baseline ICS use (Yes/No) and region as fixed effects with center nested within region as a random effect. (NCT01202188)
Timeframe: Week 12, Week 26

,,,,
InterventionScore on a scale (Least Squares Mean)
12 Weeks26 Weeks (n=441,443,430,450,196)
Glycopyrronium (NVA237)39.4038.19
Indacaterol (QAB149)38.5538.10
Indacaterol and Glycopyrronium (QVA149)37.5637.01
Placebo41.5540.02
Tiotropium39.9439.14

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Pulmonary Function Test (RV) Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using the pulmonary function test for Residual Volume (RV) on day 1 and day 21, at 5 min and 15 min post dose as determined by body plethysmography. (NCT01294787)
Timeframe: day 1 and day 21

,,
InterventionLiters (Least Squares Mean)
Day 1 - 5 min post-doseDay 1 - 15 min post-doseDay 21- 5 min post-doseDay 21- 15 min post-dose
Placebo3.943.894.033.96
QVA1493.663.633.583.54
Tiotropium3.893.663.693.59

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Pulmonary Function Test (SGaw) Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using the pulmonary function test for Specific Airway Conductance (SGaw) on day 1 and day 21, at 5 min and 15 min post dose as determined by body plethysmography. (NCT01294787)
Timeframe: day 1 and day 21

,,
InterventionKilo Pascal per second (Least Squares Mean)
Day 1- 5 min post-doseDay 1- 15 min post-doseDay 21- 5 min post-doseDay 21- 15 min post-dose
Placebo0.500.500.500.47
QVA1490.710.710.760.79
Tiotropium0.580.790.640.67

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Pulmonary Function Test Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using the pulmonary function test for Slow Vital Capacity (SVC) on day 1 and day 21, at 5 min and 15 min post dose as determined by body plethysmography. (NCT01294787)
Timeframe: day 1 and day 21

,,
InterventionLiters (Least Squares Mean)
Day 1- 5 min post-doseDay 1- 15 min post-doseDay 21- 5 min post-doseDay 21- 15 min post-dose
Placebo3.143.163.083.09
QVA1493.373.433.373.38
Tiotropium3.223.323.263.29

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Dynamic Inspiratory Capacity Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using dynamic inspiratory capacity at isotime during sub-maximal constant load cycle ergometry test ((SMETT)a cycle exercise test), after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionLiters (Least Squares Mean)
QVA1492.42
Tiotropium2.29
Placebo2.11

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Exercise Endurance Comparison Between QVA149 and Tiotropium Groups

Effect of QVA149 110/50 µg o.d. compared with tiotropium 18 µg o.d. in patients with moderate to severe COPD with respect to exercise endurance was measured by a sub-maximal constant load cycle ergometry test ((SMETT)cycle exercise test) after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionSeconds (Least Squares Mean)
Indacaterol and Glycopyrronium Bromide (QVA149)507.8
Tiotropium514

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Exercise Endurance Time Comparison After a Single Dose of QVA149 Versus Placebo

The effect of a single dose of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured with respect to exercise endurance time during sub-maximal constant load cycle ergometry test ((SMETT)cycle exercise test). (NCT01294787)
Timeframe: Day 1

InterventionSeconds (Least Squares Mean)
QVA149492.8
Tiotropium481.0
Placebo468.8

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Exercise Tolerance Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured by exercise endurance time (in seconds) during a sub-maximal constant load cycle ergometry test ((SMETT)which is a cycle exercise test) after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionSeconds (Least Squares Mean)
QVA149507.8
Placebo448.3

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Exertional Dyspnea Comparison Between QVA149 and Placebo Groups

"The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using exertional dyspnea Borg CR10 Scale® (After 3 weeks of treatment, before, during and after exercise, patients were asked to rate the intensity of their breathing and leg discomfort using the Borg CR10 Scale®). This scale consists of 12-point score that the participants pointed to so as to indicate their level of dyspnea before and during exercise testing (where 0 indicates no breathlessness at all and 12 indicates maximum breathlessness).~A reduction in this score indicates an improvement." (NCT01294787)
Timeframe: 3 weeks

Interventionunits on a scale (Least Squares Mean)
QVA1493.77
Tiotropium3.59
Placebo3.87

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Leg Discomfort During Exercise Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo on leg discomfort was measured using Borg CR10 Scale® during sub-maximal constant load cycle ergometry test after three weeks treatment. (NCT01294787)
Timeframe: 3 weeks

Interventionunits on a scale (Least Squares Mean)
QVA1494.53
Tiotropium4.57
Placebo4.43

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Spirometry After Three Weeks of Treatment on Patients Not Exercising

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using dynamic inspiratory capacity post-dose pre-exercise after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionLiters (Least Squares Mean)
Indacaterol and Glycopyrronium Bromide (QVA149)2.34
Tiotropium2.19
Placebo2.01

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Trough 24 Hour Post Dose Forced Expiratory Volume in One Second Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using trough 24 hour post dose Forced Expiratory Volume in one second (FEV1) after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionLiters (Least Squares Mean)
QVA1491.53
Tiotropium1.43
Placebo1.33

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Trough 24 Hour Post Dose Inspiratory Capacity Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using trough 24 hour post dose inspiratory capacity after three weeks of treatment. (NCT01294787)
Timeframe: 3 weeks

InterventionLiters (Least Squares Mean)
QVA1492.25
Tiotropium2.10
Placebo2.06

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Pulmonary Function Test (FRC) Comparison Between QVA149 and Placebo Groups

The effect of indacaterol and glycopyrronium bromide (QVA149) compared to placebo was measured using the pulmonary function test for Functional Residual Capacity (FRC) on day 1 and day 21, at 5 min and 15 min post dose as determined by body plethysmography. (NCT01294787)
Timeframe: day 1 and day 21

,,
InterventionLiters (Least Squares Mean)
Day 1- 5 min post-doseDay 1- 15 min post-doseDay 21- 5 min post-doseDay 21- 15 min post-dose
Placebo4.984.925.004.91
QVA1494.684.624.584.53
Tiotropium4.784.634.664.55

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Number of Participants With Adverse Events

The assessment of safety was based on Adverse Events. A summary of adverse events is presented with this outcome, additional details are provided in Adverse Events Section. (NCT01315249)
Timeframe: 26 weeks

,
Interventionparticipants (Number)
Any Adverse EventDeathSerious Adverse EventsDiscontinued due to Adverse EventsDiscontinued due to Serious Adverse EventsDiscontinued due to non-Serious Adverse Events
Fluticasone/Salmeterol15911427918
QVA14914301322517

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

Participants maintained a diary to record the daily number of puffs of rescue medication used to treat COPD symptoms. (NCT01315249)
Timeframe: Baseline, 12 weeks and 26 weeks

,
Interventionpuffs (Least Squares Mean)
Weeks 1 to12Weeks 1 to 26
Fluticasone/Salmeterol-1.90-1.93
QVA149-2.18-2.32

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Inspiratory Capacity (IC) at All-time Points (26 Weeks)

After 26 weeks of treatment, Inspiratory Capacity (IC) was measured via spirometry, conducted according to internationally accepted standards. The mean of 3 acceptable measurements was calculated and reported in liters. (NCT01315249)
Timeframe: 26 weeks

,
InterventionLiters (Least Squares Mean)
-20 minutes (n=53 QVA149; 63 flut/salm)25 minutes (n=58 QVA149; 63 flut/salm)1 hour (n=53 QVA149; 63 flut/salm)3 hours (n=52 QVA149; 60 flut/salm)7 hours (n=56 QVA149; 61 flut/salm)11 hours (n=57 QVA149; 66 flut/salm)
Fluticasone/Salmeterol2.222.342.352.322.302.27
QVA1492.252.412.382.332.402.37

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Inspiratory Capacity (IC) at All-time Points (12 Weeks)

After 12 weeks of treatment, Inspiratory Capacity (IC) was measured via spirometry, conducted according to internationally accepted standards. The mean of 3 acceptable measurements was calculated and reported in liters. (NCT01315249)
Timeframe: 12 weeks

,
InterventionLiters (Least Squares Mean)
-20 minutes (n=51 QVA149; 65 flut/salm)25 minutes (n=56 QVA149; 71 flut/salm)1 hour (n=59 QVA149; 68 flut/salm)3 hours (n=54 QVA149; 67 flut/salm)7 hours (n=58 QVA149; 67 flut/salm)11 hours (n=49 QVA149; 72 flut/salm)
Fluticasone/Salmeterol2.312.422.432.452.412.34
QVA1492.392.552.542.522.422.40

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Forced Vital Capacity at All-time Points (Week 26)

"Forced Vital Capacity (FVC) is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry. A positive change from baseline in FVC indicates improvement in lung function.~This outcome measures absolute values at -45 min, -15 min predose; 5 min, 30 min, 1 hr, 2hr, 4 hr, 8 hr, 12 hr post-dose on week 26. Results are obtained from linear mixed model." (NCT01315249)
Timeframe: -45 min, -15 min predose; 5 min, 30 min, 1 hr, 2hr, 4 hr, 8 hr, 12 hr post-dose on week 26

,
Interventionliters (Least Squares Mean)
-45 minutes (n=213 QVA149; 216 flut/salm)-15 minutes (n=213 QVA149; 215 flut/salm)5 minutes (n=212 QVA149; 215 flut/salm)30 minutes (n=212 QVA149; 214 flut/salm)1 hour (n=212 QVA149; 216 flut/salm)2 hours (n=212 QVA149; 216 flut/salm)4 hours (n=212 QVA149; 215 flut/salm)8 hours (n=212 QVA149; 216 flut/salm)12 hours (n=211 QVA149; 213 flut/salm)
Fluticasone/Salmeterol3.133.123.173.233.233.293.283.213.18
QVA1493.323.333.423.473.503.513.453.403.40

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Forced Vital Capacity at All-time Points (Week 12)

"Forced Vital Capacity (FVC) is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry. A positive change from baseline in FVC indicates improvement in lung function.~This outcome measures absolute values at -45 min, -15 min predose; 5 min, 30 min, 1 hr, 2hr, 4 hr, 8 hr, 12 hr post-dose week 12. Results are obtained from linear mixed model." (NCT01315249)
Timeframe: -45 min, -15 min predose; 5 min, 30 min, 1 hr, 2hr, 4 hr, 8 hr, 12 hr post-dose on week 12

,
Interventionliters (Least Squares Mean)
-45 minutes (n=230 QVA149; 237 flut/salm)-15 minutes (n=228 QVA149; 235 flut/salm)5 minutes (n=229 QVA149; 236 flut/salm)30 minutes (n=229 QVA149; 235 flut/salm)1 hour (n=228 QVA149; 236 flut/salm)2 hours (n=229 QVA149; 237 flut/salm)4 hours (n=228 QVA149; 237 flut/salm)8 hours (n=228 QVA149; 237 flut/salm)12 hours (n=228 QVA149; 236 flut/salm)
Fluticasone/Salmeterol3.163.173.203.233.263.313.333.273.26
QVA1493.373.373.443.483.493.543.493.463.45

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Change From Baseline in Symptom Scores Reported Using the Ediary

"Participants maintained an ediary to record daily symptom scores (AM and PM) over 12 weeks and 26 weeks of treatment. This analysis compares the mean symptom scores over 12 weeks and 26 weeks compared to baseline. The diary records morning and evening daily clinical symptoms including cough, wheezing, shortness of breath, sputum volume, sputum purulence, night time awakenings and rescue medication use.~Scale ranges: ranges are 0 to 3 with varying scale descriptions that pertain to the question being asked.~0 is the minimum score = none or No symptoms or never or No~= mild, a little~= moderate~= severe For the scale range provided, high values represent a worse outcome." (NCT01315249)
Timeframe: 12 weeks and 26 weeks

,
Interventionunits on a scale (Least Squares Mean)
Weeks 1-12Weeks 1-26
Fluticasone/Salmeterol-1.17-1.24
QVA149-1.08-1.28

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

Standardized Forced Expiratory Volume in 1 Second (FEV1) was measured with spirometry conducted according to internationally accepted standards. Measurements were made between 0 and 12 hours after treatment. FEV1 was normalized by 12 hours (divided by time). This outcome measures absolute values at week 12. Results are obtained from linear mixed model. (NCT01315249)
Timeframe: Week 12

Interventionliters (Least Squares Mean)
QVA1491.71
Fluticasone/Salmeterol1.59

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Forced Expiratory Volume in 1 Second Area Under the Curve (FEV1 AUC) 0-12

Forced Expiratory Volume in one second (FEV1) was calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. FEV1 was normalized by 12 hours (divided by time). This outcome measures absolute values at week 26. Results are obtained from linear mixed model. (NCT01315249)
Timeframe: Week 26

Interventionliters (Least Squares Mean)
QVA1491.69
Fluticasone/Salmeterol1.56

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Focal Score of the Transitional Dyspnea Index (TDI)

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement. (NCT01315249)
Timeframe: 12 weeks and 26 weeks

,
Interventionunits on a scale (Least Squares Mean)
12 weeks (n=224 QVA149; 236 flut/salm)26 weeks (n=212 QVA149; 213 flut/salm)
Fluticasone/Salmeterol1.451.60
QVA1492.032.36

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Total Score of the St. George's Respiratory Questionnaire (SGRQ-C)

The total score of the St. George's Respiratory Questionnaire (SGRQ-C) is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity, and impacts. The lowest possible value is zero and the highest 100. Higher values correspond to greater impairment in quality of life. (NCT01315249)
Timeframe: 12 weeks and 26 weeks

,
Interventionunits on a scale (Least Squares Mean)
12 weeks (n=230 QVA149; 238 flut/salm)26 weeks (n=211 QVA149; 216 flut/salm)
Fluticasone/Salmeterol36.0336.68
QVA14936.7435.45

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Number of Participants With One or More Adjudicated Events of Bleeding (Major or Non-major) With Onset Within 24 Hours After Study Drug Administration

"Post-treatment events of bleeding were evaluated by a medically-qualified, blinded member of the surgical team (Blinded Safety Assessor), in consultation with the surgeon, to determine if an event was a suspected, unanticipated adverse event of bleeding (SUAEB). A SUAEB is an event of bleeding outside the usual boundaries of expectations for a participant (e.g., in amount of blood lost, prolonged duration of bleeding, or other factors) considering the type of procedure as well as participant's specific surgical experience and underlying risk of bleeding. In addition, blinded review of clinical and laboratory databases was performed to identify any event potentially consistent with a SUAEB; these were reviewed by the Blinded Safety Assessor, who determined if any was a SUAEB. All SUAEBs were evaluated by a blinded external Adjudication Committee, which classified each as either: 1) a major bleeding event, 2) a non-major bleeding event, or 3) not an unanticipated event of bleeding." (NCT01422304)
Timeframe: Up to 24 hours post study drug administration

Interventionparticipants (Number)
Sugammadex17
Usual Care24

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Number of Participants With One or More Adjudicated Events of Bleeding (Major or Non-major) With Onset Within 14 Days After Study Drug Administration

"This Measure is identified in study protocol as an Other Secondary Outcome Measure. Post-treatment events of bleeding were evaluated by a medically-qualified, blinded member of the surgical team (Blinded Safety Assessor), in consultation with the surgeon, to determine if an event was a suspected, unanticipated adverse event of bleeding (SUAEB). A SUAEB is an event of bleeding outside the usual boundaries of expectations for a participant considering the type of procedure as well as participant's specific surgical experience and underlying risk of bleeding. In addition, blinded review of clinical and laboratory databases was performed to identify any event potentially consistent with a SUAEB; these were reviewed by the Blinded Safety Assessor, who determined if any was a SUAEB. All SUAEBs were evaluated by a blinded external Adjudication Committee, which classified each as either: 1) a major bleeding event, 2) a non-major bleeding event, or 3) not an unanticipated event of bleeding." (NCT01422304)
Timeframe: Up to 14 days post study drug administration

Interventionparticipants (Number)
Sugammadex24
Usual Care27

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Number of Participants With One or More Postoperative Anemia Adverse Events With Onset Within 72 Hours After Study Drug Administration

This measure is the incidence of postoperative anaemia with an onset within 72 hours after study drug administration. A participant is included in the count for this measure if an adverse event with any of the following event terms occurred in the participant with onset within the defined time frame: postoperative anaemia, anaemia, haemorrhagic anaemia, haemoglobin decreased or haemoglobin S decreased. (NCT01422304)
Timeframe: Up to 72 hours post study drug administration

Interventionparticipants (Number)
Sugammadex124
Usual Care132

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Percent Change From Baseline in Prothrombin Time (International Normalized Ratio) (PT[INR]) at 10 and 60 Minutes Post Study Drug Administration

Change from baseline in PT(INR) is identified in study protocol as an Other Secondary Outcome Measure. Blood samples for determination of PT(INR) values were obtained at baseline and at 10 and 60 minutes after study drug administration. PT(INR) is a performance indicator measuring the efficacy of the extrinsic and common blood coagulation (blood clotting) pathways. The INR is the ratio of a participant's prothrombin time to a normal (control) sample, raised to the power of the International Sensitivity Index (ISI) value for the analytical system used (INR = [PT-Test/PT-Normal]^ISI). Higher values of PT(INR) indicate a reduction in the clotting tendency of blood. (NCT01422304)
Timeframe: Baseline, 10 and 60 minutes post study drug administration

,
Interventionpercent change (Mean)
10 minutes (Sugammadex n=526, Usual Care n=507)60 minutes (Sugammadex n=524, Usual Care n=505)
Sugammadex8.08.9
Usual Care2.53.4

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Number of Participants With One or More Adjudicated Major Events of Bleeding With Onset Within 14 Days After Study Drug Administration

This Measure is identified in study protocol as an Other Secondary Outcome Measure. All SUAEB were evaluated by a blinded external Adjudication Committee. MBE = one or more of the following: 1) Fatal bleeding; 2) Bleeding that is symptomatic and occurs in critical area/organ, in a non-operated joint, or is intramuscular with compartment syndrome; 3) Extrasurgical site bleeding causing a fall in Hgb level of 20 g/L (1.24 mmol/L) or more, or leading to transfusion of two or more units of whole blood or RBCs, occurring within 24 hours of the bleeding; 4) Surgical site bleeding requiring second intervention, or bleeding at operated joint that interferes with rehabilitation; or 5) Surgical site bleeding that is unexpected/prolonged and/or causes hemodynamic instability, with fall in Hgb level of at least 20 g/L (1.24 mmol/L) or transfusion of at least two units of whole blood or RBCs, occurring within 24 hours of the bleeding. (NCT01422304)
Timeframe: Up to 14 days post study drug administration

Interventionparticipants (Number)
Sugammadex18
Usual Care23

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Number of Participants With One or More Adjudicated Venous Thromboembolic (VTE) Events With Onset Within 14 Days After Study Drug Administration

This Measure is identified in study protocol as an Other Secondary Outcome Measure. Suspected symptomatic VTE events were evaluated by a blinded external Adjudication Committee. The confirmation of a VTE event was based on determination of a clinically meaningful venous thrombosis (e.g., pulmonary embolism or deep vein thrombosis). (NCT01422304)
Timeframe: Up to 14 days post study drug administration

Interventionparticipants (Number)
Sugammadex5
Usual Care3

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Number of Participants With One or More Adjudicated Events of Anaphylaxis With Onset Within 14 Days After Study Drug Administration

This Measure is identified in study protocol as an Other Secondary Outcome Measure. Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Adverse events suggestive of hypersensitivity which met defined criteria (e.g., serious event) and/or suspected events of anaphylaxis were evaluated by a blinded external Adjudication Committee to determine whether such events met either of the following two criteria for anaphylaxis (Sampson et al. J Allergy Clin Immunol 2006;117:391-7) - 1. Acute onset of an illness with involvement of the skin, mucosal tissue or both, and at least one of the following: a) respiratory compromise, b) reduced blood pressure (BP) or associated symptoms of end-organ dysfunction. 2. Two or more of the following that occur rapidly after exposure to a likely allergen for that participant: a) involvement of the skin-mucosal tissue, b) respiratory compromise, c) reduced BP or associated symptoms, d) persistent gastrointestinal symptoms. (NCT01422304)
Timeframe: Up to 14 days post study drug administration

Interventionparticipants (Number)
Sugammadex0
Usual Care0

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Number of Participants Requiring Any Postoperative Transfusion

The number of participants who received a transfusion unit (e.g., whole blood, packed RBCs, cell saver RBCs, fresh frozen plasma, platelets) that started after study drug administration and within 120 hours after study drug administration (or within 48 hours after any previous [i.e., predose] transfusion for participants who had received a previous transfusion) was determined. (NCT01422304)
Timeframe: From end of study drug administration through approximately 120 hours after study drug administration

Interventionparticipants (Number)
Sugammadex221
Usual Care227

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Number of Participants With One or More Adjudicated Major Events of Bleeding With Onset Within 24 Hours After Study Drug Administration

This Measure is identified in study protocol as an Other Secondary Outcome Measure. All SUAEB were evaluated by a blinded external Adjudication Committee. Major bleeding event (MBE) = one or more of the following: 1) Fatal bleeding; 2) Bleeding that is symptomatic and occurs in critical area/organ, in a non-operated joint, or is intramuscular with compartment syndrome; 3) Extrasurgical site bleeding causing a fall in hemoglobin (Hgb) level of 20 g/L (1.24 mmol/L) or more, or leading to transfusion of two or more units of whole blood or red blood cells (RBCs), occurring within 24 hours of the bleeding; 4) Surgical site bleeding requiring second intervention, or bleeding at operated joint that interferes with rehabilitation; or 5) Surgical site bleeding that is unexpected/prolonged and/or causes hemodynamic instability, with fall in Hgb level of at least 20 g/L (1.24 mmol/L) or transfusion of at least two units of whole blood or RBCs, occurring within 24 hours of the bleeding. (NCT01422304)
Timeframe: Up to 24 hours post study drug administration

Interventionparticipants (Number)
Sugammadex12
Usual Care20

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Percent Change From Baseline in Activated Partial Thromboplastin Time (aPTT) at 10 and 60 Minutes Post Study Drug Administration

Change from baseline in aPTT is identified in study protocol as the Key Secondary Outcome Measure. Blood samples for determination of aPTT values were obtained at baseline and at 10 and 60 minutes after study drug administration. aPTT is a performance indicator measuring the efficacy of the intrinsic and common blood coagulation (blood clotting) pathways. Higher values of aPTT indicate a reduction in the clotting tendency of blood. (NCT01422304)
Timeframe: Baseline, 10 and 60 minutes post study drug administration

,
Interventionpercent change (Mean)
10 minutes (Sugammadex n=525, Usual Care n=507)60 minutes (Sugammadex n=523, Usual Care n=505)
Sugammadex6.00.4
Usual Care-0.1-1.2

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Total Transfusion Volume in Participants Who Required Postoperative Transfusion

"Among participants who received a transfusion unit (e.g., whole blood, packed RBCs, cell saver RBCs, fresh frozen plasma, platelets) that started after study drug administration and within 120 hours after study drug administration (or within 48 hours after any previous [i.e., predose] transfusion for participants who had received a previous transfusion), the total volume of blood transfused post study drug was calculated. The volume of blood transfused post study drug (using linear interpolation when transfusions were ongoing at the time of study drug administration) was converted to grams of Hgb transfused, using RBC concentration information received from the investigators. The sum of Hgb transfused was standardized to normal volume Hgb in homologous whole blood, using 20 g/dL Hgb for calculation of the standardized volume." (NCT01422304)
Timeframe: From end of study drug administration through approximately 120 hours after study drug administration

InterventionmL (Geometric Mean)
Sugammadex335
Usual Care345

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Postoperative Drainage Volume Within 24 Hours After Study Drug Administration

The total volume of postoperative drainage from the surgical site over the 24 hours after study drug administration was recorded. (NCT01422304)
Timeframe: Up to 24 hours post study drug administration

InterventionmL (Mean)
Sugammadex464
Usual Care476

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Postoperative Changes in Hgb Concentrations Using the Bleeding Index

The Bleeding Index was used to describe postoperative changes in Hgb concentrations at Visit 3. Bleeding Index = Hgb level at Visit 3 - Hgb level at baseline, adjusted for the amount of RBCs transfused. Missing baseline Hgb values were imputed using the overall mean Hgb value at baseline. (NCT01422304)
Timeframe: Baseline and Visit 3 (24-48 hours post study drug administration)

Interventiong/L (Mean)
Sugammadex-15.7
Usual Care-17.4

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Incidence of Residual Neuromuscular Blockade (NMB) as Defined by a Train-of-Four (TOF) Ratio <0.9 at Post Anesthesia Care Unit (PACU) Entry

Neuromuscular functioning was monitored by applying four TOF electrical stimulations to the ulnar nerve and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the magnitudes (height) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB, with a higher ratio indicating greater recovery from NMB. A T4/T1 Ratio of <0.9 is indicative of residual NMB. (NCT01479764)
Timeframe: At PACU entry on Day 1

Interventionparticipants (Number)
Sugammadex0
Neostigmine/Glycopyrrolate33

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Time From Start of Study Drug Administration to Operating Room Discharge-ready

The time of operating room discharge readiness was determined by the surgical team based on clinical evaluations. (NCT01479764)
Timeframe: Day 1

Interventionminutes (Least Squares Mean)
Sugammadex15.02
Neostigmine/Glycopyrrolate18.05

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Total Total Transient Dyspnea Index (TDI) Score After 6 Weeks of Treatment QVA149 Compared to Tiotropium

Total Transient Dyspnea Index (TDI) is part of the BDI/TDI questionnaire where participants indicated whether they improved or deteriorated since their Baseline Dyspnea Index (BDI). The BDI and TDI each had 3 domains: activities, tasks, and effort. BDI domains were rated from 0 (very severe) to 4 (none) and the rates summed for the total BDI score ranging from 0 to 12; the lower the score the worse the severity of dyspnea. TDI domains were rated from -6 (major deterioration) to 6 (major improvement) and the rates summed for the total TDI score ranging from -18 to 18. However, to ensure comparability with the TDI paper version, all TDI values were divided by 2 before the analysis. If data was missing or insufficient for any one of the domains a BDI/TDI was calculated. BDI = Baseline Dyspnea Index taken 75 min prior to the first dose in each treatment period. TDI = Transition Dyspnea Index taken after 6 weeks of treatment 75 min prior to the last dose in each treatment period. (NCT01490125)
Timeframe: Baseline and 6 weeks

,
InterventionUnits on a scale (Mean)
BDITDI
QVA149 + Placebo to Tiotropium7.340.98
Tiotropium + Placebo to QVA1497.310.47

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Total Total Transient Dyspnea Index (TDI) Score After 6 Weeks of Treatment QVA149 Compared to Placebo

Total Transient Dyspnea Index (TDI) is part of the BDI/TDI questionnaire where participants indicated whether they improved or deteriorated since their Baseline Dyspnea Index (BDI). The BDI and TDI each had 3 domains: activities, tasks, and effort. BDI domains were rated from 0 (very severe) to 4 (none) and the rates summed for the total BDI score ranging from 0 to 12; the lower the score the worse the severity of dyspnea. TDI domains were rated from -6 (major deterioration) to 6 (major improvement) and the rates summed for the total TDI score ranging from -18 to 18. However, to ensure comparability with the TDI paper version, all TDI values were divided by 2 before the analysis. If data was missing or insufficient for any one of the domains a BDI/TDI was calculated. BDI = Baseline Dyspnea Index taken 75 min prior to the first dose in each treatment period. TDI = Transition Dyspnea Index taken after 6 weeks of treatment 75 min prior to the last dose in each treatment period. (NCT01490125)
Timeframe: Baseline and 6 weeks

,
InterventionUnits on a scale (Mean)
BDITDI
Placebo7.33-0.38
QVA149 + Placebo to Tiotropium7.340.98

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Change From Baseline in the Mean Daily Number of Puffs of Rescue Medication Used Over the 6 Weeks of Treatment

The number of puffs of rescue medication taken by participants, were collected each day during the study via entries in e-diaries (NCT01490125)
Timeframe: Baseline and 6 weeks

Interventionpuffs (Least Squares Mean)
QVA149 + Placebo to Tiotropium-1.02
Tiotropium + Placebo to QVA149-0.57
Placebo0.41

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Standardized Forced Vital Capacity (FVC) Area Under the Curve (AUC) 5min-4 Hrs After First Dose and 6 Weeks of Treatment With QVA149 Compared to Placebo and Tiotropium

Forced Vital Capacity (FVC) is the total amount of air that can be exhaled by the patient after a full inhalation. The FVC was measured via spirometry conducted according to internationally accepted standards at 5 min-4 hr post dose of day 1 and week 6. (NCT01490125)
Timeframe: 5min-4hr at day 1 and week 6 post-dose

,,
InterventionLiters (Least Squares Mean)
Day 1 (n=210,219,217)Week 6 (n= 205,209,206)
Placebo3.0202.957
QVA149 + Placebo to Tiotropium3.3403.393
Tiotropium + Placebo to QVA1493.2493.269

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Change From Baseline in The Capacity of Daily Living During the Morning (CDLM) Score Averaged Over 6 Weeks of Treatment

"The Capacity of Daily Living during the Morning (CDLM) is a self-administered daily assessment. The CDLM asks COPD patients to (i) report their ability to carry out 6 morning activities and (ii) rate the difficulty in performing those activities on a five point Likert-type scale ranging from not at all difficult to extremely difficult. For each of the six morning activities a score ranging from 0 (=so difficult that they could not carry out the activity by themselves) to 5 (not at all difficult to carry out the activity by themselves) is calculated by using the responses from the two questions for each activity. Daily CDLM is calculated using the scores average from the 6 morning activities. CDLM is calculated as the average daily CDLM score over 6 weeks of treatment. The change from baseline in CDLM score over 6 weeks is analyzed using a MIXED model with baseline CDLM score as a covariate. A CDLM score of 0.20 is considered to be a minimal clinically important difference." (NCT01490125)
Timeframe: Baseline and 6 weeks

InterventionUnits on a scale (Least Squares Mean)
QVA149 + Placebo to Tiotropium0.09
Tiotropium + Placebo to QVA1490.08
Placebo-0.01

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Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 5min-4h After First Dose and 6 Weeks of Treatment With QVA149 Compared to Placebo and Tiotropium

Forced Expiratory Volume in 1 second (FEV1) was measured with spirometry conducted according to internationally accepted standards. Measurements were taken at 5 min- 4hr post-dose of day 1 and week 6. The standardized FEV1 Area under the curve (AUC) was calculated as the sum of trapezoids divided by the length of time. (NCT01490125)
Timeframe: 5min-4hr at day 1 and week 6 post-dose

,,
InterventionLiters (Least Squares Mean)
Day 1 (n=220,219,2117)Week 6 (n=205,209,206)
Placebo1.3521.302
QVA149 + Placebo to Tiotropium1.5641.636
Tiotropium + Placebo to QVA1491.4961.529

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Mean Percentage of Nights With 'no Nighttime Awakenings'

A night with 'no nighttime awakenings' is defined from diary data as any night where patient did not wake up due to symptoms. Total number of nights with 'no nighttime awakenings' over treatment period was divided by total number of nights where diary recordings have been made in order to derive percentage of 'no nighttime awakenings' which will be summarized by treatment and analyzed using a similar mixed model as specified for primary analysis. Diary data recorded during the 7 day run-in period was used to calculate baseline percentage of nights 'no nighttime awakenings'. (NCT01513460)
Timeframe: 12 weeks

InterventionPercentage of nights (Mean)
NVA237 + Fluticasone/Salmeterol (Flu/Sal)0.834
Tiotropium + Flu/Sal0.816
Flu/Sal0.823

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Mean Percentage of Days With Performance of Usual Activities

A 'day able to perform usual daily activities' was defined from diary data as any day where the patient was not prevented from performing their usual daily activities due to respiratory symptoms. The percentage of 'days able to perform usual daily activities' was derived and analyzed using a similar mixed model as specified for primary analysis as for the percentage of nights with 'no nighttime awakenings'. (NCT01513460)
Timeframe: 12 weeks

InterventionPercentage of days (Mean)
NVA237 + Fluticasone/Salmeterol (Flu/Sal)0.934
Tiotropium + Flu/Sal0.946
Flu/Sal0.903

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Change From Baseline in Total Score of the St George's Respiratory Questionnaire for COPD Patients (SGRQ-C) After 12 Weeks of Treatment

SGRQ-C is a health related quality of life questionnaire consisting of 40 items divided into two components: 1) symptoms, 2) activity& impacts. The lowest possible value is zero and the highest is 100. Higher values corresponded to greater impairment in quality of life. An analysis model included terms for treatment, baseline total SGRQ score, FEV1 and baseline smoking status. The model also contained as fixed effects the baseline total SGRQ score, FEV1 prior to inhalation of short acting bronchodilator, FEV1 post inhalation of short acting bronchodilator and stratification factors as covariates. A negative change from baseline indicates improvement. (NCT01513460)
Timeframe: 12 weeks

Interventionunits on a scale (Mean)
NVA237 + Fluticasone/Salmeterol (Flu/Sal)-2.806
Tiotropium + Flu/Sal-3.902
Flu/Sal-0.652

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

The total number of puffs of rescue medication used over the last 12 h recorded in the morning (nighttime use) and in the evening (daytime use) over the full 12 weeks was divided by the total number of days with non-missing rescue data to derive the mean daytime and nighttime number of puffs of rescue medication. Change from baseline in the mean daytime and nighttime number of puffs of rescue medication was analyzed as for the change from baseline in the mean daily number of puffs of rescue medication. (NCT01513460)
Timeframe: baseline, 12 weeks

Interventionpuffs of rescue medication (Mean)
NVA237 + Fluticasone/Salmeterol (Flu/Sal)2.191
Tiotropium + Flu/Sal2.093
Flu/Sal2.908

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Change From Baseline in Mean Trough Forced Expiratory Volume in 1 Second (FEV1) (NVA237 Versus Tiotropium)

Spirometry was conducted according to internationally accepted standards. Trough FEV1 referred to the mean of FEV1 at 23:15 hours and 23:45 hours after the morning dose of study drug. The baseline was defined as the average of FEV1 values taken in the clinic 45 min and 15 min prior to the first dose of randomized treatment at Visit 3. A mixed model was used and contained treatment as a fixed effect with the baseline measurement of trough FEV1, FEV1 prior to inhalation of short acting bronchodilators, and FEV1 post-inhalation of bronchodilators and stratification factors as covariates. A positive change from baseline indicates improvement. (NCT01513460)
Timeframe: baseline, 12 weeks

Interventionliters (Mean)
NVA237 + Fluticasone/Salmeterol (Flu/Sal)0.095
Tiotropium + Flu/Sal0.102

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Change From Baseline in Mean Trough FEV1

Spirometry was conducted according to internationally accepted standards. Trough FEV1 referred to the mean of FEV1 at 23:15h and 23:45h after the morning dose of study drug. The baseline was defined as the average of FEV1 values taken in the clinic 45min and 15min prior to the first dose of randomized treatment at Visit 3. A mixed model was used and contained treatment as a fixed effect with the baseline measurement of trough FEV1, FEV1 prior to inhalation of short acting bronchodilators, and FEV1 post-inhalation of bronchodilators and stratification factors as covariates. A positive change from baseline indicates improvement. (NCT01513460)
Timeframe: baseline, 4 weeks, 8 weeks, 12 weeks

,,
InterventionLiters (Mean)
Week 4Week 8Week 12
Flu/Sal-0.010-0.002-0.012
NVA237 + Fluticasone/Salmeterol (Flu/Sal)0.0770.0840.089
Tiotropium + Flu/Sal0.0770.0920.087

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Change From Baseline in Mean Trough FEV1 (Flu/Sal Versus NVA237/Tiotropium+Flu/Sal)

Spirometry was conducted according to internationally accepted standards. Trough FEV1 referred to the mean of FEV1 at 23:15h and 23:45h after the morning dose of study drug. The baseline was defined as the average of FEV1 values taken in the clinic 45min and 15min prior to the first dose of randomized treatment at Visit 3. A mixed model was used and contained treatment as a fixed effect with the baseline measurement of trough FEV1, FEV1 prior to inhalation of short acting bronchodilators, and FEV1 post-inhalation of bronchodilators and stratification factors as covariates. A positive change from baseline indicates improvement. (NCT01513460)
Timeframe: baseline, 4 weeks, 8 weeks, 12 weeks

,
InterventionLiters (Mean)
Week 4Week 8Week 12
Flu/Sal-0.010-0.002-0.012
NVA237/Tiotropium+Flu/Sal0.0770.0880.088

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Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28

Time course of Forced Expiratory Volume in 1 second (FEV1) was measured at -45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28. FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation. (NCT01529632)
Timeframe: -45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28

,
InterventionLiters (Least Squares Mean)
-45 min predose (n=76,90)-15 predose (n=72,87)5 min postdose (n=76,89)30 min postdose (n=76,88)1 hour postdose (n=77,90)2 hours postdose (n=77,90)3 hours postdose (n=78,91)4 hours postdose (n=77,84)
QAB149 + NVA2371.4601.4301.5141.5441.6041.6241.5871.556
QVA1491.4521.4491.4911.5291.5841.6011.5761.554

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Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-dose

Spirometry was conducted according to internationally accepted standards. Peak FEV1 is the maximum FEV1 recorded in the period between 5 minutes and 4 hours post dose. Analysis of Covariance was carried out with a mixed model that used (period) baseline, defined as the value of FEV1 measured prior to the first study drug intake in the period, as a covariate. (NCT01529632)
Timeframe: 5 min - 4 hr at Days 1 and 28

,
InterventionLiters (Least Squares Mean)
Day 1 (n=83, 97)Day 28 (n= 80, 92)
QAB149 + NVA2371.6461.654
QVA1491.6681.643

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Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of Treatment

The number of puffs of rescue medication taken in the previous 12 hours was recorded in the Patient Diary in the morning and evening. The total number of puffs of rescue medication per day over the whole active treatment period was calculated and divided by the total number of days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient. If the number of puffs was missing for part of the day (either morning or evening) then a half day was used in the denominator. (NCT01529632)
Timeframe: Baseline and 28 days

,
Interventionpuffs (Mean)
Baseline (day 1)28 days after treatment
QAB149 + NVA2372.041.70
QVA1492.241.85

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Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of Treatment

The mean total symptom scores and mean individual symptom scores for the patient were calculated for the whole study period. The mean change from baseline in the total scores and in the individual scores were summarized by treatment and were analyzed for the percentage of 'nights with no nighttime awakenings'. The symptom variables for the whole active treatment period was analyzed using the similar MIXED model as for the primary endpoint, with the baseline FEV1 term being replaced by the respective baseline symptom variables. (NCT01529632)
Timeframe: 28 days

,
Interventionpercentage of days (Mean)
Baseline (day 1)After 28 days of treatment
QAB149 + NVA2373.96.0
QVA1496.29.3

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Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 28

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 28 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country. (NCT01529632)
Timeframe: 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 28

InterventionLiters (Least Squares Mean)
QVA1491.575
QAB149 + NVA2371.587

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Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 1

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 1 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country. (NCT01529632)
Timeframe: 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 1

InterventionLiters (Least Squares Mean)
QVA1491.597
QAB149 + NVA2371.573

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Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded Treatment

Spirometry was conducted according to internationally accepted standards. Trough FEV1 is defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FEV1 readings measured at day 29, after 28 days of treatment. Mixed model: Trough FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country. (NCT01529632)
Timeframe: Day 29

InterventionLiters (Least Squares Mean)
QVA1491.459
QAB149 + NVA2371.465

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Change From Baseline in Daily Rescue Medication Use (Number of Puffs)

The participant recorded the rescue medication taken in an electronic diary between visits and in the spirometry device during study visits. Daytime and nighttime rescue medication use (number of puffs) over 26 weeks was analyzed. (NCT01566604)
Timeframe: Baseline, 26 weeks

InterventionNumber of puffs (Least Squares Mean)
NVA237-0.77
Placebo-0.55

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Number of Moderate and Severe COPD Exacerbations

COPD exacerbations were recorded in the patient diary and other source documents. The rate of COPD exacerbations during the 26 week treatment period was analyzed using a generalized linear model assuming a negative binomial distribution. (NCT01566604)
Timeframe: 26 weeks

InterventionNumber of exacerbations (Mean)
NVA2370.2
Placebo0.3

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Time to First Moderate or Severe COPD Exacerbation

A COPD exacerbation was defined as a worsening of the following two or more major symptoms for at least 2 consecutive days:1) dyspnea; 2) sputum volume; 3) sputum purulence; or defined as a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: 1) sore throat; 2) colds (nasal discharge and/or nasal congestion); 3) fever without other cause; 4) cough; 5) wheeze. COPD exacerbations were recorded in the patient diary and other source documents. (NCT01566604)
Timeframe: 26 weeks

InterventionDays (Median)
NVA237NA
PlaceboNA

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Trough Forced Expiratory Volume in One Second (FEV1)

Baseline FEV1 was defined as the average of the -45 min and -15 min FEV1 values taken on day 1 prior to the first dose of study medication. Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. FEV1 was measured using central spirometry according to ATS/ERS standardization. Trough FEV1 was analyzed using a MIXED model for the full analysis set population. The model contained treatment as a fixed effect with the baseline FEV1 measurement, FEV1 prior to inhalation of short acting bronchodilator, FEV1 45 min post inhalation of short acting bronchodilator and baseline inhaled corticosteroids (ICS) use as covariates. (NCT01566604)
Timeframe: 12 weeks

InterventionLiters (Least Squares Mean)
NVA2371.204
Placebo1.063

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24h Trough FEV1

Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. This was measured using central spirometry according to ATS/ERS standardization. This was analyzed using the same MIXED model as specified for the primary analysis. (NCT01566604)
Timeframe: Day 1, Week 26

,
InterventionLiters (Least Squares Mean)
Day 1 (n=289,151)Week 26 (n=281,143)
NVA2371.2301.195
Placebo1.1091.059

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Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Symptoms (Cough, Wheezing, Shortness of Breath, Sputum Volume, Sputum Color and Night Time Awakenings)

In an electronic diary, the participant responded to 6 questions twice daily to report on the degree of symptoms over the past 12 hours of the morning and evening. The questions covered the participant's degree of overall symptoms, and degrees of individual symptoms of coughing, wheezing, amount of sputum, color of sputum and breathlessness. Each question scored from 0 to 3 where 0 represented no symptom present and 3 represented the worst degree of that symptom. A negative change in symptom score indicates improvement. (NCT01566604)
Timeframe: Baseline, 26 weeks

,
Interventionscore (Least Squares Mean)
Total symptom (n=296,150)Respiratory symptomCough symptomWheeze symptomSputum productionSputum colorBreathless symptom
NVA237-1.16-0.21-0.24-0.30-0.15-0.10-0.17
Placebo-0.85-0.12-0.20-0.22-0.11-0.10-0.10

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FEV1 and Forced Vital Capacity (FVC)

FEV1 and FVC were measured using central spirometry according to ATS/ERS standardization. Both were analyzed using the same MIXED model as specified for the primary analysis. (NCT01566604)
Timeframe: Day 1 at 5, 15, 30 minutes (min) and 1 hour (h) post dose; days 2, 86, 184 at 23 (h) 15 min and 23 h 45 min post dose; days 29, 85, 183 at -45 and -15 min pre-dose and 5, 15, and 30 min post dose

,
InterventionLiters (Least Squares Mean)
FEV1, day 1, 5 min (n=281,143)FEV1, day 1, 15 min (n=277,147)FEV1, day 1, 30 min (n=283,145)FEV1, day 1, 1 h (n=284,142)FEV1, day 2, 23 h 15 min (n=267,137)FEV1, day 2, 23 h 45 min min (n=272,140)FEV1, day 29, -45 min (n=273,136)FEV1, day 29, -15 min (n=280,142)FEV1, day 29, 5 min (n=271,136)FEV1, day 29, 15 min (n=272,135)FEV1, day 29, 30 min (n=279,139)FEV1, day 85, -45 min (n=269,130)FEV1, day 85, -15 min (n=271,136)FEV1, day 85, 5 min (n=262,130)FEV1, day 85, 15 min (n=267,133)FEV1, day 85, 30 min (n=273,137)FEV1, day 85, 1 h (n=274,133)FEV1, day 86, 23 h 15 min (n=261,127)FEV1, day 86, 23 h 45 min (n=250,132)FEV1, day 183, -45 min (n=262,135)FEV1, day 183, - 15 min (n=265,135)FEV1, day 183, 5 min (n=262,135)FEV1, day 183, 15 min (n=261,140)FEV1, day 183, 30 min (n=270,138)FEV1, day 183, 1 h (n=263,135)FEV1, day 184, 23 h 15 min (n=263,128)FEV1, day 184, 23 h 45 min (n=266,132)FVC, day 1, 5 min (n=281,143)FVC, day 1, 15 min (n=277,147)FVC, day 1, 30 min (n=283,145)FVC, day 1, 1 h (n=284,142)FVC, day 2, 23 h 15 min (n=267,137)FVC, day 2, 23 h 45 min (n=272,140)FVC, day 29, -45 min (n=273,136)FVC, day 29, -15 min (n=280,142)FVC, day 29, 5 min (n=271,136)FVC, day 29, 15 min (n=272,135)FVC, day 29, 30 min (n=279,139)FVC, day 85, -45 min (n=269,130)FVC, day 85, -15 min (n=271,136)FVC, day 85, 5 min (n=262,130)FVC, day 85, 15 min (n=267,133)FVC, day 85, 30 min (n=273,137)FVC, day 85, 1 h (n=274,133)FVC, day 86, 23 h 15 min (n=261,127)FVC, day 86, 23 h 45 min (n=250,132)FVC, day 183, -45 min (n=262,135)FVC, day 183, -15 min (n=265,135)FVC, day 183, 5 min (n=262,135)FVC, day 183, 15 min (n=261,140)FVC, day 183, 30 min (n=270,138)FVC, day 183, 1 h (n=263,135)FVC, day 184, 23 h 15 min (n=263,128)FVC, day 184, 23 h 45 min (n=266,132)
NVA2371.1991.2451.2651.2951.2281.2301.2081.2261.2401.2591.2721.1791.1901.2291.2461.2631.2751.1951.2031.1761.1791.2201.2331.2651.2631.1971.1962.9252.9923.0413.0442.9532.9812.9082.9272.9702.9932.9952.8542.8982.9272.9542.9772.9872.9082.8942.8582.8622.9272.9572.9882.9412.8692.894
Placebo1.1121.1161.1111.1241.1011.1071.0791.0971.0971.1031.1051.0501.0521.0591.0611.0771.0791.0571.0671.0321.0521.0551.0701.0711.0751.0681.0582.7392.7592.7612.7552.7162.7442.6902.7302.7252.7512.7372.6112.6272.6332.6472.6952.6622.6122.6712.6042.6332.6722.6792.7072.6682.6642.647

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Peak FEV1

Peak FEV1 was defined as the maximum FEV1 0-4 h post-dose. Peak Fev1 was measured at 45min and 15min pre-dose and up to 4h post dose at day 1, week 12 and week 26, using central spirometry according to ATS/ERS standardization. It was analyzed using the same MIXED model as specified for the primary analysis. (NCT01566604)
Timeframe: Day 1, week 12, week 26

,
InterventionLiters (Least Squares Mean)
Day 1 (n=134,57)Week 12 (n=125,56)Week 26 (n=124,57)
NVA2371.3761.3471.308
Placebo1.1831.1401.112

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Standardized FEV1 Area Under the Curve (AUC(5 Min-4 h)) Post-dose

The standardized (with respect to time) AUC for FEV1 was calculated between 5 min and 4h post morning dose at day 1, week 12 and week 26. The AUC (5 min-4 h) for FEV1 at each visit was analyzed using the same MIXED model as specified for the primary analysis. (NCT01566604)
Timeframe: Day 1, week 12, week 26

,
InterventionLiters (Least Squares Mean)
Day 1 (n=134,57)Week 12 (n=125,56)Week 26 (n=124,57)
NVA2371.3111.2861.243
Placebo1.1171.0801.046

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The Total Score of the St George's Respiratory Questionnaire (SGRQ)

SGRQ is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity and impacts. The lowest possible score is zero and the highest possible score is 100. Higher scores correspond to greater impairment in quality of life. The health-related quality of life was measured using SGRQ. It was completed by the participant at the investigators site. (NCT01566604)
Timeframe: Week 12, week 26

,
InterventionScore (Least Squares Mean)
week 12 (n=293,147)week 26 (n=288,144)
NVA23732.3531.02
Placebo37.3935.94

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Transition Dyspnea Index (TDI) Score

Dyspnea was measured at baseline using the Baseline Dyspnea Index (BDI) and during the treatment period using the TDI, which captures changes from baseline. The BDI and TDI each have three domains: functional impairment, magnitude of task and magnitude of effort, and each domain scored from -3 (major deterioration) to +3 (major improvement), giving an overall score of -9 to +9. A negative score indicates deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01566604)
Timeframe: Baseline, week 12, week 26

,
Interventionscore (Least Squares Mean)
week 12 (n=288,141)week 26 (n=284,140)
NVA2372.83.0
Placebo1.62.0

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Trough FEV1 at Baseline and Week 26

Trough FEV1 is the mean value of FEV1 (forced expiratory volume in one second) measured at 23:15h and 23:45h after the morning doses. The baseline value was measured at day 1 prior to the first dose. (NCT01574651)
Timeframe: Baseline, Week 26

,
InterventionLiters (Mean)
BaselineWeek 26
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol1.3291.495
Tiotropium Plus Formoterol and Placebo to QVA1491.3131.409

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Percent of Participants With at Least One Exacerbation Requiring Hospitalization

The percent of patients with at least one severe exacerbation within the 26 weeks that required hospitalization. COPD exacerbations were considered to be severe if hospitalization were required. (NCT01574651)
Timeframe: Week 26

InterventionPercent of participants (Number)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol2.1
Tiotropium Plus Formoterol and Placebo to QVA1492.4

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Percent of Participants With at Least One Exacerbation Requiring Systemic Corticosteroids and/or Antibiotics Over 26 Weeks

The percent of participants with at least one moderate exacerbation within the 26 weeks that required systemic corticosteroids and/or antibiotics during the treatment (NCT01574651)
Timeframe: Week 26

InterventionPercent of participants (Number)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol10.9
Tiotropium Plus Formoterol and Placebo to QVA14913.3

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Time- Event Analysis, Number of Participants With at Least One COPD Exacerbation (Moderate or Severe) During the Treatment Period

The number of participants with at least one moderate or severe COPD exacerbation. COPD exacerbations are considered to be moderate if treatment with systemic corticosteroids and/or antibiotics was required. COPD exacerbations are considered to be severe if hospitalizations were required. (NCT01574651)
Timeframe: Week 26

InterventionParticipants (Number)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol62
Tiotropium Plus Formoterol and Placebo to QVA14970

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"Symptoms Score Reported by the Patients Using Part I Symptoms of SGRO-C"

"Part I of the SGRQ-C covers symptoms and is concerned with respiratory symptoms, their frequency and severity. Each questionnaire response has a unique empirically derived weight. A score was calculated from these weights. The lowest possible value is zero and the highest 100. A higher value corresponds to greater impairment of health status." (NCT01574651)
Timeframe: Baseline, Week 26

,
InterventionScore on a scale (Mean)
Baseline (n=473,457)Week 26 (n=476,458)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol64.1058.31
Tiotropium Plus Formoterol and Placebo to QVA14964.2960.16

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FEV1 30 Min After the Morning Dose at Baseline and Week 26

FEV1 30min is the forced expiratory volume in one second measured 30 min after the morning dose. (NCT01574651)
Timeframe: Baseline, Week 26

,
InterventionLiters (Mean)
Baseline (n=475,458)Week 26 (n=476,458)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol1.5171.605
Tiotropium Plus Formoterol and Placebo to QVA1491.4951.565

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St. George's Respiratory Questionnaire (SGRQ-C) Total Score After 26 Weeks of Treatment (Non-inferiority Analysis).

SGRQ is a health related quality of life questionnaire consisting of 40 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. For patients who completed the study but with missing SGRQ-C during treatment, the missing SGRQ-C were replaced by the last observation carried forward (LOCF). Symptom scores were expected to improve over treatment, therefore the replacement of missing values with earlier measurements did not result in overoptimistic imputation and this procedure could be regarded as conservative. (NCT01574651)
Timeframe: Baseline, week 26

,
InterventionScore on a scale (Mean)
Baseline (n=452,441)Week 26 (n=475,456)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol44.7041.30
Tiotropium Plus Formoterol and Placebo to QVA14945.6843.19

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Transition Dyspnea Index (TDI) Focal Score After 26 Weeks of Treatment.

Baseline Dyspnea Index (BDI)/Transition Dyspnea Index (TDI) focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. BDI was measured at day 1 prior to the first dose with domain scores ranging from 0=very severe to 4=no impairment and a total score ranging from 0 to 12(best). TDI captures changes from baseline. Each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. missing values were replaced by the latest observed value (LOCF) (NCT01574651)
Timeframe: Week 26

InterventionUnits on a scale (Mean)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol1.34
Tiotropium Plus Formoterol and Placebo to QVA1490.87

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St. George's Respiratory Questionnaire (SGRQ-C) Total Score After 26 Weeks of Treatment (Superiority Analysis).

SGRQ is a health related quality of life questionnaire consisting of 40 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. For patients who completed the study but with missing SGRQ-C during treatment, the missing SGRQ-C were replaced by the last observation carried forward (LOCF). Symptom scores were expected to improve over treatment, therefore the replacement of missing values with earlier measurements did not result in overoptimistic imputation and this procedure could be regarded as conservative. Superiority of QVA 110/50 μg to tiotropium 18 μg q.d. plus formoterol 12 μg b.i.d. in terms of health related quality of life as assessed by St George's Respiratory Questionnaire (SGRQ-C) after 26 weeks of treatment (NCT01574651)
Timeframe: Baseline, week 26

,
InterventionScore on a scale (Mean)
Baseline (n=452,441)Week 26 (n=475,456)
QVA149 Plus Placebo to Tiotropium and Placebo to Formoterol44.7041.30
Tiotropium Plus Formoterol and Placebo to QVA14945.6843.19

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Change From Baseline in Mean Daily Total and Individual Symptom Scores

The symptoms (respiratory, cough, wheeze, sputum color, sputum production, breathlessness, sore throat, nasal discharge or congestion, and fever) for the whole active treatment period was analyzed using a mixed model, which contained treatment, baseline smoking status and baseline ICS use as fixed effects with the baseline symptom score, FEV1 prior to inhalation of short acting bronchodilators and FEV1 post inhalation of short acting bronchodilators as covariates and center nested in region as a random effect. Each symptom was scored as 0, 1, 2 or 3 where the description for each score varied. For each of the symptoms, the range of scores from 0 to 3 represented an increase in symptoms where 0 represented little to no symptom and 3 represented severe or worst symptom. The total symptom score, which is the sum of the individual scores, ranged from 0 (best possible outcome) to 27 (worst possible outcome). (NCT01604278)
Timeframe: Baseline, 12 weeks

,
InterventionScore (Least Squares Mean)
Total symptom scoreRespiratory symptom scoreCough symptom scoreWheeze symptom scoreSputum production scoreSputum color scoreBreathless symptom scoreSore throat symptom scoreCold symptom scoreFever symptom score
NVA237 + Indacaterol-1.2-0.3-0.2-0.3-0.1-0.1-0.20.00.00.0
Placebo to NVA237 + Indacaterol-1.1-0.2-0.2-0.2-0.1-0.1-0.20.00.00.0

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

The number of puffs of rescue medication taken in the previous 12 hours was recorded in the patient diary in the morning and evening. The total number of puffs of rescue medication per day over the whole active treatment period was calculated and divided by the total number of days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient. If the number of puffs was missing for part of the day (either morning or evening), then a half day was used in the denominator. (NCT01604278)
Timeframe: Baseline, 12 weeks

InterventionNumber of puffs (Least Squares Mean)
NVA237 + Indacaterol-1.9
Placebo to NVA237 + Indacaterol-1.8

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FEV(1) Area Under the Curve (AUC) During 30 Minutes to 4 Hours Post Dose

Centralized spirometry was used according to internationally accepted standards was used. The trapezoidal rule was applied to calculate FEV1 Area Under the Curve (AUC) and then normalized to the length of time. Whether the participants had complete or incomplete FEV1 assessments in respective time ranges, their AUCs were calculated based on the existing FEV1 measurements (i.e., the missing FEV1 measurements were not interpolated). Specifically, for those participants who had a FEV1 assessment at only one time-point, their AUC was approximated by the observed FEV1. FEV1 measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were not included in the analysis. (NCT01604278)
Timeframe: 12 weeks

InterventionLiters (Least Squares Mean)
NVA237 + Indacaterol1.641
Placebo to NVA237 + Indacaterol1.530

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Peak FEV1 During 30 Minutes to 4 Hours Post-dose at 12 Weeks

Centralized spirometry was used according to internationally accepted standards was used. Peak FEV1 was defined as the maximum FEV1 during the first 4 hours post morning dosing. The model contained treatment, baseline smoking status and baseline ICS use as fixed effects with the baseline measurement of FEV1, FEV1 prior to inhalation of short acting bronchodilators and FEV1 post inhalation of short acting bronchodilator as covariates and center nested in a region as a random effect. If all FEV1 measurements were missing from 30 minutes onward, the peak FEV1 was not calculated. FEV1 measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were not included in the analysis. (NCT01604278)
Timeframe: 12 weeks

InterventionLiters (Least Squares Mean)
NVA237 + Indacaterol1.702
Placebo to NVA237 + Indacaterol1.596

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Transitional Dyspnea Index (TDI) Focal Score

Dyspnea was measured at baseline using the Baseline Dyspnea Index (BDI) and during treatment using the Transitional Dyspnea Index (TDI). Analysis was done via mixed model. 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 is considered a minimal clinically important difference. (NCT01604278)
Timeframe: baseline, 12 weeks

InterventionScore (Least Squares Mean)
NVA237 + Indacaterol2.506
Placebo to NVA237 + Indacaterol2.012

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Trough Forced Expiratory Volume at 1 Second (FEV1)

Centralized spirometry according to internationally accepted standards was used. The model contained treatment, baseline smoking status and baseline inhaled corticosteroid (ICS) use as fixed effects with the baseline measurement of FEV1, FEV1 prior to inhalation of short acting bronchodilators and FEV1 post inhalation of short acting bronchodilator as covariates and center nested in region as a random effect. If trough FEV1 was missing at week 12, the latest non-missing pre-dose trough FEV1 (the mean of 45 and 15 min pre-dose measurements) from day 29, 57 or 84) was carried forward. These measurements had to have been taken before the next dose of study medication. FEV1 measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were not included in the analysis. (NCT01604278)
Timeframe: 12 weeks

InterventionLiters (Least Squares Mean)
NVA237 + Indacaterol1.499
Placebo to NVA237 + Indacaterol1.436

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Number of Participants With Adverse Events and Serious Adverse Events

All study emergent adverse events including Chronic Obstructive Pulmonary Disease exacerbations were monitored from screening through the end of study. (NCT01604278)
Timeframe: 12 weeks

,
InterventionNumber of participants (Number)
Adverse Events (serious and non-serious)Serious adverse eventsDeaths
NVA237 + Indacaterol8550
Placebo to NVA237 + Indacaterol7550

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Inspiratory Capacity (IC) at Individual Time-points

Inspiratory Capacity (IC) was measured at 20 min pre-dose and at post-dose at 25 minutes, 1 hour 55 minutes, 3 hours 55 minutes and 23 hours 40 minutes, by visit. The model contained treatment, baseline smoking status and baseline ICS use as fixed effects with the baseline measurement of IC, FEV1 prior to inhalation of short acting bronchodilators and FEV1 post inhalation of short acting bronchodilators as covariates and center nested in region as a random effect. IC measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were set to missing. (NCT01604278)
Timeframe: Day 1, Days 84/85

,
InterventionLiters (Least Squares Mean)
Day 1, 25 min post dose (n=164,168)Day 1, 1 h 55 min (n=161,176)Day 1, 3 h 55 min (n=160,173)Days 84/85, 20 min pre-dose (n=144,148)Days 84/85, 25 min post dose (n=149,145)Days 84/85, 1 h 55 min post dose (n=146,153)Days 84/85, 3 h 55 min (n=146,145)Days 84/85, 23 h 40 min (n=153,150)
NVA237 + Indacaterol2.4932.5872.5572.4442.5802.6072.5772.405
Placebo to NVA237 + Indacaterol2.4342.4782.4752.3632.4202.4852.4392.337

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Forced Vital Capacity (FVC) at Individual Time-points

FVC was calculated at each time point up to 4 hours post-dose and at 23 hours 15 minutes and 23 hours 45 minutes, by visit. The model contained treatment, baseline smoking status and baseline ICS use as fixed effects with the baseline measurement of FVC, FEV1 prior to inhaltion of short acting bronchodilators and FEV1 post inhaltion of short acting bronchodilators as covariates and center nested in region as a random effect. FVC measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were set to missing. (NCT01604278)
Timeframe: Day 1, Day 29, Day 57 and Days 84/85

,
InterventionLiters (Least Squares Mean)
Day 1, 30 min post dose (n=208,199)Day 1, 1 h post dose (n=214,209)Day 1, 2 h post dose (n=212,207)Day 1, 4 h post dose (n=206,213)Day 1, 23 h 15 min post dose (n=201,203)Day 1, 23 h 45 min post dose (n=213,204)Day 29, 45 min pre-dose (n=198,202)Day 29, 15 min pre-dose (n=198,200)Day 29, 30 min post dose (n=202,201)Day 29, 1 h post dose (n=200,199)Day 56, 45 min pre-dose (n=201,202)Day 56, 15 min pre-dose (n=199,198)Day 56, 30 min post dose (n=200,200)Day 56, 1 h post dose (n=197,204)Days 84/85, 45 min pre-dose (n=201,206)Days 84/85, 15 min pre-dose (n=190,196)Days 84/85, 30 min post dose (n=198,199)Days 84/85, 1 h post dose (n=201,200)Days 84/85, 2 h post dose (n=198,201)Days 84/85, 4 h post dose (n=200,198)Days 84/85, 23 h 15 min post dose (n=193,188)Days 84/85, 23 h 45 min post dose (n=197,199)
NVA237 + Indacaterol3.2143.2953.3253.3403.1553.2013.1463.1843.3163.3623.1023.1563.2823.3273.0523.0643.2463.3123.3183.2513.1233.136
Placebo to NVA237 + Indacaterol3.1353.1823.2003.2183.0393.0953.0433.0923.2013.1973.0153.0863.1903.2193.0163.0123.1623.1793.1813.1613.0503.047

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FEV1 at Individual Time-points

Centralized spirometry according to internationally accepted standards was used. FEV1 was measured at all post-dose time points up to 4 hours, and at 23 hours 15 minutes and 23 hours 45 minutes, by visit. The model contained treatment, baseline smoking status and baseline ICS use as fixed effects with the baseline measurement of FEV1, FEV1 prior to inhaltion of short acting bronchodilators and FEV1 post inhaltion of short acting bronchodilators as covariates and center nested in region as a random effect. FEV1 measurements within 6 hours of rescue medication use or within 7 days of systemic corticosteroid use were not included in the analysis. (NCT01604278)
Timeframe: Day 1, Day 29, Day 57 and Days 84/85

,
InterventionLiters (Least Squares Mean)
Day 1, 30 minutes (min) post dose (n=208,199)Day 1, 1 hour (h) post dose (n=214,209)Day 1, 2 h post dose (n=212,207)Day 1, 4 h post dose (n=206,213)Day 1, 23 h 15 min post dose (n=201,203)Day 1, 23 h 45 min post dose (n=213,204)Day 29, 45 min pre-dose (n=198,202)Day 29, 15 min pre-dose (n=198,200)Day 29, 30 min post dose (n=202,201)Day 29, 1 h post dose (n=200,199)Day 56, 45 min pre-dose (n=201,202)Day 56, 15 min pre-dose (n=199,198)Day 56, 30 min post dose (n=200,200)Day 56, 1 h post dose (n=197,204)Days 84/85, 45 min pre-dose (n=201,206)Days 84/85, 15 min pre-dose (n=190,196)Days 84/85, 30 min post dose (n=198,199)Days 84/85, 1 h post dose (n=201,200)Days 84/85, 2 h post dose (n=198,201)Days 84/85, 4 h post dose (n=200,198)Days 84/85, 23 h 15 min post dose (n=193,188)Days 84/85, 23 h 45 min post dose (n=197,199)
NVA237 + Indacaterol1.5441.5891.6261.6301.4811.5021.4911.5241.6171.6481.4821.5091.6061.6341.4591.4761.6041.6381.6651.6201.4741.508
Placebo to NVA237 + Indacaterol1.4671.4791.5061.5181.4091.4251.4381.4701.5081.5241.4181.4431.4951.5201.4111.4391.5141.5141.5421.5291.4261.452

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Trough Forced Expiratory Volume in 1 Second (FEV1) After 12 Weeks of Treatment (Analysis of Superiority)

FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing. The trough in FEV1 was defined as the mean of two measurements at 23h 15min and 23h 45min post dosing. ANCOVA model: Trough FEV1 = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). This analysis excluded values within 6 hours of rescue medication use or 7 days of systemic corticosteroid. (NCT01613326)
Timeframe: Week 12

InterventionLiters (Least Squares Mean)
NVA2371.398
Tiotropium1.393

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Transition Dyspnea Index (TDI) Focal Score After 4 Weeks and 12 Weeks of Treatment

"Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.~ANCOVA model: TDI focal score = treatment + Baseline dyspnea index (BDI) + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region." (NCT01613326)
Timeframe: Weeks 4 and 12

,
InterventionUnits on a scale (Least Squares Mean)
Week 4 (n= 289, 287)Week 12 (n= 290, 285)
NVA2372.2091.990
Tiotropium2.0862.178

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Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Week 4

"FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing.~Trough FEV1 is defined as the average of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. Trough assessments taken outside 22 h 45 min - 24 h 15 min are excluded from this analysis.~ANCOVA model: Trough FEV1 = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region." (NCT01613326)
Timeframe: Day 1 and Week 4

,
InterventionLiters (Least Squares Mean)
Day 1 (n=296, 288)Week 4 (n=284, 280)
NVA2371.3851.416
Tiotropium1.3861.416

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Peak Forced Expiratory Volume in 1 Second (FEV1) During 5 Min to 4 Hours Post-dose, at Day 1 and Week 12

Spirometry was conducted according to internationally accepted standards. Peak FEV1 is the maximum FEV1 recorded during first 4 hours post dose. ANCOVA model: Peak FEV1 = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center (region). Center is included as a random effect nested within region. This analysis excludes values within 6 hours of rescue medication use or 7 days of systemic corticosteroid use. (NCT01613326)
Timeframe: 5 min to 4 hours post-dose at Day 1 and Week 12

,
InterventionLiters (Least Squares Mean)
Day 1 (n= 298, 292)Week 12 (n= 290, 282)
NVA2371.5751.577
Tiotropium1.5201.553

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St. George's Respiratory Questionnaire Total Score After 12 Weeks of Treatment

St. George's Respiratory Questionnaire (SGRQ) is a health related quality of life questionnaire consisting of 51 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. ANCOVA model: SGRQ total score = treatment + baseline SGRQ score + baseline ICS use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center (region). (NCT01613326)
Timeframe: Week 12

InterventionUnits on a scale (Least Squares Mean)
NVA23739.42
Tiotropium38.77

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Trough Forced Expiratory Volume in 1 Second (FEV1) After 12 Weeks of Treatment (Non-inferiority Analysis)

Forced Expiratory Volume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing. The trough in FEV1 was defined as the mean of two measurements at 23hours 15min and 23 hours 45min post dosing. ANCOVA model: Trough FEV1 = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center (region). This analysis excluded values within 6 hours of rescue medication use or 7 days of systemic corticosteroid use. (NCT01613326)
Timeframe: Week 12

InterventionLiters (Least Squares Mean)
NVA2371.405
Tiotropium1.405

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Change From Baseline in Mean Daily Number of Puffs of Rescue Medication Used Over the 12 Week Treatment

"A day with no rescue medication use is defined from the diary data as any day where the patient recorded no rescue medicine use during the previous 12 hours.~Baseline mean daily, daytime and nighttime (combined) number of puffs is defined as the average of the respective number of puffs. Only patients with a value at both baseline and post-baseline visits were included." (NCT01613326)
Timeframe: Baseline and Day 1 to Week 12

,
Interventionpuffs (Mean)
BaselineDay 1 to week 12
NVA2374.092.76
Tiotropium4.102.84

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Event Free Rate at Weeks 4, 8 and 12 After Treatment

Event free rate was calculated as a percentage of participants who did not experience any moderate or severe COPD exacerbation leading to hospitalization/treatment with systemic corticosteroids/treatment with antibiotics. The event free rate reflects the percent of patients who did NOT have an exacerbation by 4, 8 and 12 weeks. Event-free rates are calculated at the end of the specified weeks (i.e. Day 29, Day 57 and Day 85) by the Kaplan Meier method. (NCT01613326)
Timeframe: Weeks 4, 8 and 12

,
Interventionpercentage of participants (Number)
Week 4Week 8Week 12
NVA23795.692.990.2
Tiotropium96.693.892.4

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Forced Expiratory Volume in 1 Second (FEV1) at Each Time-point by Visit

Forced Expiratory Volume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation. FEV1 was analyzed using Analysis of Covariance (ANCOVA) model: FEV1 = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region. (NCT01613326)
Timeframe: (5,15,30 min, 1, 2,3,4 h, 23h 15 min and 23h 45 min postdose of Day 1), (-45, -15 min predose, 5,15,30 min, 1h, 23h 15 min and 23h 45 min postdose of Week 4), (-45, -15 min predose, 5,15,30 min, 1, 2, 3,4 h, 23h 15 min and 23h 45 min postdose of Week 12)

,
InterventionLiters (Least Squares Mean)
Day 1, 5 min (n= 283, 278)Day 1, 15 min (n= 282, 276)Day 1, 30 min (n= 285, 281)Day 1, 1 hour (n= 291, 286)Day 1, 2 hours (n= 290, 286)Day 1, 3 hours (n= 291, 285)Day 1, 4 hours (n= 285, 281)Day 1, 23 h 15 min (n= 289, 279)Day 1, 23 h 45 min (n= 285, 278)Week 4, -45 min (n= 280, 280)Week 4, -15 min (n= 278, 279)Week 4, 5 min (n= 277, 274)Week 4, 15 min (n= 271, 270)Week 4, 30 min (n= 272, 276)Week 4, 1 hr (n= 280, 282)Week 4, 23 h 15 min (n= 278, 276)Week 4, 23 h 45 min (n= 274, 276)Week 12, -45 min (n= 286, 279)Week 12, -15 min (n= 283, 279)Week 12, 5 min (n= 283, 271)Week 12, 15 min (n= 275, 271)Week 12, 30 min (n= 282, 278)Week 12, 1 hr (n= 286, 279)Week 12, 2 hours (n= 278, 277)Week 12, 3 hours (n= 281, 279)Week 12, 4 hours (n= 282, 280)Week 12, 23 h 15 min (n= 276, 266)Week 12, 23 h 45 min (n= 278, 276)
NVA2371.3821.4281.4421.4821.5171.5271.4901.3841.3811.4031.3881.4221.4591.4541.5131.4221.4181.3941.3771.4301.4401.4611.5001.5071.5061.4731.4141.415
Tiotropium1.3311.3651.3791.4191.4541.4711.4481.3841.3791.3911.3931.4231.4661.4421.4941.4171.4161.3801.3701.4111.4231.4321.4751.4841.4841.4621.4221.420

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Forced Vital Capacity (FVC) at Each Time-point by Visit

Forced Vital Capacity (FVC) is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry. ANCOVA model: FVC = treatment + baseline FVC + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region. (NCT01613326)
Timeframe: (5,15,30 min, 1, 2,3,4 h, 23h 15 min and 23h 45 min postdose of Day 1), (-45, -15 min predose, 5,15,30 min, 1h, 23h 15 min and 23h 45 min postdose of Week 4), (-45, -15 min predose, 5,15,30 min, 1, 2, 3,4 h, 23h 15 min and 23h 45 min postdose of Week 12)

,
InterventionLiters (Least Squares Mean)
Day 1, 5 min (n= 283, 278)Day 1, 15 min (n= 282, 276)Day 1, 30 min (n= 285, 281)Day 1, 1 hour (n= 291, 286)Day 1, 2 hours (n= 290, 286)Day 1, 3 hours (n= 291, 285)Day 1, 4 hours (n= 285, 281)Day 1, 23 h 15 min (n= 289, 279)Day 1, 23 h 45 min (n= 285, 278)Week 4, -45 min (n= 280, 280)Week 4, -15 min (n= 278, 279)Week 4, 5 min (n= 277, 274)Week 4, 15 min (n= 271, 270)Week 4, 30 min (n= 272, 276)Week 4, 1 hr (n= 280, 282)Week 4, 23 h 15 min (n= 278, 276)Week 4, 23 h 45 min (n= 274, 276)Week 12, -45 min (n= 286, 279)Week 12, -15 min (n= 283, 279)Week 12, 5 min (n= 283, 271)Week 12, 15 min (n= 275, 271)Week 12, 30 min (n= 282, 278)Week 12, 1 hr (n= 286, 279)Week 12, 2 hours (n= 278, 277)Week 12, 3 hours (n= 281, 279)Week 12, 4 hours (n= 282, 280)Week 12, 23 h 15 min (n= 276, 266)Week 12, 23 h 45 min (n= 278, 276)
NVA2372.9253.0043.0363.0363.0613.1353.0732.9112.9422.9332.8792.9543.0213.0053.0682.9822.9532.8892.8272.9292.9452.9633.0113.0083.0142.9642.9232.929
Tiotropium2.8742.9542.9913.0063.0293.1113.0462.9512.9512.9432.8982.9973.0583.0113.0933.0132.9782.9052.8372.9532.9632.9823.0093.0123.0182.9772.9532.955

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Inspiratory Capacity (IC) at Each Time-point, by Visit

IC was measured with spirometry conducted according to internationally accepted standards. ANCOVA model: IC = treatment + baseline IC + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region. (NCT01613326)
Timeframe: (25 min, 1 h 55 min, 3 h 55 min, 23 h 40 min Day 1), (-20 min, 25 min, 23 h 40 min Week 4),(-20 min, 25 min, 1 h 55 min, 3 h 55 min, 23 h 40 min Week 12)

,
InterventionLiters (Least Squares Mean)
Day 1, 25 min (n= 216, 214)Day 1, 1 h 55 min (n= 212, 208)Day 1, 3 h 55 min (n= 211, 207)Day 1, 23 h 40 min (n= 213, 212)Week 4, -20 min (n= 204, 204)Week 4, 25 min (n= 201, 200)Week 4, 23 h 40 min (n=199,205)Week 12, -20 min (n= 205, 204)Week 12, 25 min (n= 215, 205)Week 12, 1 h 55 min (n= 213, 203)Week 12, 3 h 55 min (n= 203, 207)Week 12, 23 h 40 min (n= 208, 206)
NVA2372.3782.4332.3432.2472.2312.3352.2842.1982.2922.3442.3132.228
Tiotropium2.3002.3352.3092.2442.2402.3342.2892.2272.2802.2892.2752.262

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Mean Daily, Daytime and Nighttime (Combined) Symptom Scores Over the 12 Week Treatment Period

Participants completed eDiaries providing scores 0 to 3 for symptoms: Cough and wheeze (none, mild, moderate, severe); sputum volume (none, less than 5 mL, 5-25 mL, >25 mL); sputum color (none, white-grey, yellow, green); lowest level of activity causing breathlessness (never or only when running, when walking uphill or upstairs, when walking on flat ground, at rest). Symptoms in the morning, for the previous night (no waking due to symptoms, woke up once due to symptoms, woke up more than once due to symptoms, woke up frequently or could not sleep due to symptoms). Symptoms experienced during the day that had prevented them for performing normal activities (not at all, a little, quite a lot, completely). The mean change from baseline in the total scores and in the individual scores was summarized by treatment. Only participants with a value at both baseline and post-baseline were included. Possible total scores 0-18 (night); 0-36 (day). A higher score means worsening of symptoms. (NCT01613326)
Timeframe: 12 weeks

,
Interventionunits on a scale (Mean)
BaselineDay 1 to Week 12
NVA2377.215.96
Tiotropium6.905.96

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Standardized Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC) (5 Min-4 h) Post-dose

"Forced Expiratory Volume in one second (FEV1) was measured with spirometry conducted according to internationally accepted standards.~Area Under the Curve (AUC) is calculated using the trapezoidal rule using the existing FEV1 measurements (i.e., the missing FEV1 measurements are not interpolated).~ANCOVA model: FEV1 AUC = treatment + baseline FEV1 + baseline Inhaled corticosteroid (ICS) use (Yes/No) + FEV1 reversibility components + baseline smoking status + region + center(region). Center is included as a random effect nested within region." (NCT01613326)
Timeframe: Day 1 and week 12

,
InterventionLiters (Least Squares Mean)
Day 1 (n=298, 292)Week 12 (290, 282)
NVA2371.4961.493
Tiotropium1.4381.470

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Time to Premature Discontinuation of Treatment

methodTime to premature treatment discontinuation for each treatment group was displayed using a Kaplan-Meier curve. The date of last dose of study medication was considered as the event date and also as the censoring date for those patients who did not discontinue treatment earl (NCT01682863)
Timeframe: 56 weeks

InterventionDays (Median)
QVA149 27.5/12.5 ug Bid384.0
QVA149 27.5/25 ug BidNA
QAB149 75 ug odNA

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Change From Baseline in 1 Hour Post-dose FEV1 Measurements

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. (NCT01682863)
Timeframe: Day 1, 29, 57, 85, 141, 197, 253, 309, and 365

,,
InterventionLiters (Least Squares Mean)
Day 1Day 29Day 57Day 85Day 141Day 197Day 253Day 309Day 365
QAB149 75 ug od0.1220.1730.1730.1700.1700.1570.1400.1250.104
QVA149 27.5/12.5 ug Bid0.1660.2570.2670.2690.2680.2290.2310.1990.212
QVA149 27.5/25 ug Bid0.1780.2870.3020.3010.2880.2780.2400.2220.221

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Change From Baseline in FVC Measurement at All Post-baseline Time Points

Pulmonary function assessments were performed using centralized spirometry according to international standards. (NCT01682863)
Timeframe: Day1, 29, 57, 85, 141, 197, 253, 309, and 365

,,
InterventionLiters (Least Squares Mean)
Day 1Day 29Day 57Day 85Day 141Day 197Day 253Day 309Day 365
QAB149 75 ug od0.2480.2800.2790.2680.2350.2200.2050.1850.139
QVA149 27.5/12.5 ug Bid0.3160.3750.3900.3880.3820.3130.3100.2720.312
QVA149 27.5/25 ug Bid0.3490.4400.4390.4320.4030.4000.3650.3340.323

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Change From Baseline in Pre-dose Trough 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. (NCT01682863)
Timeframe: Day 29, 57,, 85, 141, 197, 253, 309 and 365

,,
InterventionLiters (Least Squares Mean)
Day 29Day 57Day 85Day 141Day 197Day 253Day 309Day 365
QAB149 75 ug od0.1090.1070.0950.0870.0790.0740.0500.037
QVA149 27.5/12.5 ug Bid0.1640.1780.1660.1740.1380.1420.0960.116
QVA149 27.5/25 ug Bid0.1940.1990.2010.1980.1810.1530.1230.116

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Number of Patients With Adverse Events, Serious Adverse Events, and Death

The overall rate of adverse events reported from initiation through 30 days post last dose. (NCT01682863)
Timeframe: 56 weeks

,,
InterventionNumber of Patients (Number)
Patients with at least one SAEsPatients with at least one AEDeath
QAB149 75 ug od241395
QVA149 27.5/12.5 ug Bid261391
QVA149 27.5/25 ug Bid251423

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Change From Baseline in Mean Total Daily Symptom Scores

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. (NCT01682863)
Timeframe: 52 weeks

InterventionScore on a scale (Least Squares Mean)
QVA149 27.5/12.5 ug Bid-1.57
QVA149 27.5/25 ug Bid-1.56
QAB149 75 ug od-1.31

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Change From Baseline in the Daily Number of Puffs of Rescue Medication Over the 52 Week Period

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. (NCT01682863)
Timeframe: 52 weeks

InterventionNumber of puffs (Least Squares Mean)
QVA149 27.5/12.5 ug Bid-1.89
QVA149 27.5/25 ug Bid-1.62
QAB149 75 ug od-1.73

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Percentage of Participants Experiencing Moderate or Severe COPD Exacerbation

Percentage of participants experiencing moderate or severe Chronic Obstructive Pulmonary Disease (COPD) (NCT01682863)
Timeframe: 52 weeks

InterventionPercentage of participants (Number)
QVA149 27.5/12.5 ug Bid23.5
QVA149 27.5/25 ug Bid24.9
QAB149 75 ug od27.0

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Change From Baseline in Pre-dose Forced Vital Capacity (FVC) at All Post-baseline Timepoints

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. (NCT01697696)
Timeframe: -45 min and -15 minutes baseline and at Week 52

,
InterventionLiters (Mean)
Day 29/-45minDay 29/-15minDay 57/-45minDay 57/-15minDay 85/-45minDay 85/-15minDay 141/-45minDay 141/-15minDay 197/-45minDay 197/-15minDay 253/-45minDay 253/-15minDay 309/-45minDay 309/-15minDay 365/-45minDay 365/-15min
NVA2370.1910.2170.1680.2100.1710.1880.1590.1820.1400.1330.1670.1530.1200.1490.1160.143
QAB1490.1700.1940.1400.1780.0940.1180.1120.1410.0750.0830.1000.1250.0940.1140.1090.097

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Change From Baseline in Pre-dose Forced Expiratory Volume (FEV1) in One Second at All Post Baseline Timepoints

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. (NCT01697696)
Timeframe: -45 min and -15 minutes baseline and at Week 52

,
InterventionLiters (Mean)
Day 29/-45minDay 29/-15minDay 57/-45minDay 57/-15minDay 85/-45minDay 85/-15minDay 141/-45minDay 141/-15minDay 197/-45minDay 197/-15minDay 253/-45minDay 253/-15minDay 309/-45minDay 309/-15minDay 365/-45minDay 365/-15min
NVA2370.1040.1230.0980.1200.1050.1110.0710.0960.0710.0730.0920.0940.0680.0880.0570.087
QAB1490.1180.1380.1010.1070.0850.0990.0890.1080.0820.0900.0870.1030.0940.1120.0880.090

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Change From Baseline in Mean Forced Expiratory Volume (Average of the Two FEV1 Measurements 45 and 15 Minutes Pre-dose) in One Second at Week 52

Change from baseline in pre-dose trough FEV1 was analyzed using a repeated measures analysis of covariance model which contained treatment, baseline FEV1, visit, baseline smoking status, baseline ICS use, COPD severity and treatment by visit, visit by baseline FEV1 interactions. An unstructured variance-covariance error matrix was used .Pulmonary function assessments were performed using centralized spirometry according to international standards. Pre-dose trough FEV1 was defined as the mean of FEV1 at -45 min and -15 min before the morning dose at Week 52. Baseline FEV1 was defined as the mean of the pre-dose FEV1 at -45 min and -15 min on Day 1. (NCT01697696)
Timeframe: -45 min and -15 minutes baseline and at Week 52

InterventionLiters (Least Squares Mean)
NVA2370.056
QAB1490.060

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Percentage of Participants Reporting Safety and Tolerability in Terms of Adverse Event (AE) Reporting Rate

Adverse events are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal lab finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgments of the investigators represent significant hazards. (NCT01697696)
Timeframe: 52 weeks

InterventionPercentage of participants (Number)
NVA23777.3
QAB14977

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Time to First COPD Exacerbation (Moderate or Severe).

COPD exacerbations are considered to be moderate if treatment with systemic corticosteroids and/or antibiotics was required. COPD exacerbations are considered to be severe if hospitalizations were required. Rates are calculated using the Kaplan Meier method. (NCT01697696)
Timeframe: 52 weeks

InterventionDays (Median)
NVA237NA
QAB149NA

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Time to Treatment Discontinuation

Discontinuation rates are calculated using the Kaplan Meier method. The protocol allowed patients to discontinue outside the treatment window, hence we have a patient who discontinued at Day 388. Reasons for discontinuing treatment are Subject/guardian decision, Adverse event, Protocol deviation Lack of efficacy, Physician decision, Dosing error, Disease improvement under study, Pregnancy, Technical problems (NCT01697696)
Timeframe: 52 Weeks

InterventionDays (Median)
NVA237NA
QAB149388

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

The number of puffs of rescue medication taken in the previous 12 hours was recorded by the patients in the eDiary in the morning and evening. The total number of puffs of rescue medication per day over the 52 week treatment period was calculated and divided by the total number of days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient. If the number of puffs was missing for part of the day (either morning or evening), then a half day was used in the denominator. Change from baseline in number of puffs were analyzed using a linear mixed model which contained treatment, baseline number of puffs, baseline smoking status, baseline ICS use and COPD disease severity as fixed effects with center as a random effect (NCT01697696)
Timeframe: 52 weeks

,
InterventionNumber of puffs (Least Squares Mean)
Daily (n=231, 227)Daytime (n=221, 220)Nighttime (n=226, 222)
NVA237-1.16-0.71-0.52
QAB149-1.79-1.05-0.73

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Change From Baseline in COPD Symptoms

The total symptom score was defined as the sum of individual cores for respiratory symptoms, cough, wheeze, amount of sputum, color of sputum, and reathlessness. Where a patient had a morning score and an evening score for an individual symptom on one particular day then the worst score was to be taken as the daily score for that symptom. Each symptom scale ranged from 0-3 where 0 was no symptoms and 3 was the worst. The total daily/daytime/nighttime symptom score consists of looking at the score for 6 symptoms and can therefore have a minimum score of 0 or a maximum of 18. (NCT01697696)
Timeframe: 52 weeks

,
Interventionscores on a scale (Least Squares Mean)
Daily total symptom score (n=231, 227)Daytime total symptom score (n=221, 220)Nighttime total symptom score (n=226, 222)
NVA237-1.18-0.95-1.11
QAB149-1.47-1.14-1.25

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Change From Baseline in COPD Symptoms

Percentage of days with 'no daytime symptoms' A day with 'no daytime symptoms' was defined from the diary data as any day where the patient had recorded in the evening no cough, no wheeze, no production of sputum and no feeling of breathlessness (other than when running) and no puffs of rescue medication during the past 12 hours (approximately 8 am to 8pm). However, a patient was not considered symptom free if they had used rescue medication that day even if his/her total daytime symptoms score was zero. Percentage of nights with 'no nighttime awakenings' A night with 'no nighttime awakenings' was defined from diary data as any night where the patient did not wake up due to symptoms. The total number of nights with 'no nighttime awakenings' over the treatment period was divided by the total number of nights where diary recordings had been made in order to derive the percentage nights with 'no nighttime awakenings'. (NCT01697696)
Timeframe: 52 weeks

,
InterventionPercentage of days / nights (Least Squares Mean)
Nights with no nighttime awakenings (n=226, 222)Days with no daytime symptoms (n=221, 220)Days able to perform daily activities(n=221,220)
NVA23717.46.05.4
QAB14918.05.18.5

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Inspiratory Capacity (IC)

During the 4 hours following inhalation of the study treatment, inspiratory capacity (IC) was measured with spirometry conducted according to internationally accepted standards. IC was measured at 30, 60, 120, 180, and 240 minutes post-dose (NCT01699685)
Timeframe: within 4h after dosing

,
InterventionLiters (Mean)
Day (0) 30 min post-doseDay (0) 1 hour post-doseDay (0) 2 hour post-doseDay (0) 3 hour post-doseDay (0) 4 hour post-doseDay (6) 30 min post-doseDay (6) 1 hour post-doseDay (6) 2 hour post-doseDay (6) 3 hour post-doseDay (6) 4 hour post-dose
Sequence A2.672.672.692.742.742.792.802.862.832.85
Sequence B2.752.792.712.692.742.402.722.742.692.68

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Inspiratory Capacity (IC) Peak Value

IC was measured with spirometry conducted according to internationally accepted standards. Peak IC was defined as the maximum IC of the mean at one of the post-dose measurements (30min, 60min, 120min, 180min and 240min). (NCT01699685)
Timeframe: Day (0) 30minutes, 1, 2, 3, and 4 hours; Day (6) 30 minutes, 1, 2, 3, and 4 hours

,
InterventionLiters (Mean)
Day 0 (n=38, 38)Day 6 (n=36, 36)
Sequence A2.872.99
Sequence B2.942.85

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Total Lung Capacity (TLC)

TLC was measured with spirometry conducted according to internationally accepted standards. Peak TLC was calculated as the mean of the three Functional Residual Capacity peak measurements plus the mean of the three Inspiratory Capacity measurements which were measured each at 30, 60, 120, 180 and 240 minutes post dose (NCT01699685)
Timeframe: Day (0) 30minutes, 1, 2, 3, and 4 hours; Day (6) 30 minutes, 1, 2, 3, and 4 hours

,
InterventionLiters (Mean)
Day (0) 30 min post-doseDay (0) 1 hour post-doseDay (0) 2 hour post-doseDay (0) 3 hour post-doseDay (0) 4 hour post-doseDay (6) 30 min post-doseDay (6) 1 hour post-doseDay (6) 2 hour post-doseDay (6) 3 hour post-doseDay (6) 4 hour post-dose
Sequence A7.207.177.067.147.217.207.127.217.237.30
Sequence B6.816.796.816.826.786.796.806.806.816.93

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Airway Resistance (Raw)

Raw was measured with spirometry conducted according to internationally accepted standards. Raw was the mean of the measurements which were measured each at 30, 60, 120, 180 and 240 minutes (NCT01699685)
Timeframe: Day (0) 30minutes, 1, 2, 3, and 4 hours; Day (6) 30 minutes, 1, 2, 3, and 4 hours

,
InterventioncmH2O/l/s (Mean)
Day (0) 30 min post-doseDay (0) 1 hour post-doseDay (0) 2 hour post-doseDay (0) 3 hour post-doseDay (0) 4 hour post-doseDay (6) 30 min post-doseDay (6) 1 hour post-doseDay (6) 2 hour post-doseDay (6) 3 hour post-doseDay (6) 4 hour post-dose
Sequence A5.135.195.215.075.184.734.474.314.304.30
Sequence B4.744.614.434.534.485.184.974.714.774.78

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Forced Expiratory Volume in One Second (FEV1)

FEV1 was measured with spirometry conducted according to internationally accepted standards. FEV1 was at 30, 60, 120, 180, and 240 minutes post-dose. Spirometry equipment and performance of spirometric testing had to be in accordance with standards as outlined in the American Thoracic Society for the Standardization of Spirometry recommendations. The spirometry equipment used during the study had to meet or exceed these minimal ATS recommendations (NCT01699685)
Timeframe: Day (0) 30minutes, 1, 2, 3, and 4 hours; Day (6) 30 minutes, 1, 2, 3, and 4 hours

,
InterventionLiters (Mean)
Day (0) 30 min post-doseDay (0) 1 hour post-doseDay (0) 2 hour post-doseDay (0) 3 hour post-doseDay (0) 4 hour post-doseDay (6) 30 min post-doseDay (6) 1 hour post-doseDay (6) 2 hour post-doseDay (6) 3 hour post-doseDay (6) 4 hour post-dose
Sequence A1.491.501.511.531.531.591.631.661.651.64
Sequence B1.571.601.601.591.601.521.531.551.561.56

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Forced Volume Capacity (FVC)

FVC was measured with spirometry conducted according to internationally accepted standards. Measurements were made 30, 60, 120, 180, and 240 minutes post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time (NCT01699685)
Timeframe: Day (0) 30minutes, 1, 2, 3, and 4 hours; Day (6) 30 minutes, 1, 2, 3, and 4 hours

,
InterventionLiters (Mean)
Day (0) 30 min post-doseDay (0) 1 hour post-doseDay (0) 2 hour post-doseDay (0) 3 hour post-doseDay (0) 4 hour post-doseDay (6) 30 min post-doseDay (6) 1 hour post-doseDay (6) 2 hour post-doseDay (6) 3 hour post-doseDay (6) 4 hour post-dose
Sequence A2.983.003.013.083.073.193.253.293.323.30
Sequence B3.003.023.043.043.072.962.972.992.982.96

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Change From Baseline of Morning and Nighttime Symptom Scores at Week 12

Patients reported symptoms using an electronic diary.The diary has 9 symptom questions each am & each pm.Each question can be answered w/1 of 4 pre-defined answers,with a unit value of 0-3, 0 is least & 3 is most severe symptom.Symptom scores are calculated as the mean of the symptom scores(either the score assessed in am for the previous 12 hrs-referred to as nighttime scores,or the score assessed in pm for the previous 12 hrs-referred to as the daytime symptom score) for each patient over 12 weeks.The baseline is calculated from the run-in epoch prior to randomization.The change from baseline is in LS mean daily symptom scores over the 12 weeks. If the mean score over the 12 weeks is lower than the baseline, result is (-).A neg. result indicates an improvement in COPD symptom severity. the # of patients analyzed can vary between both day & night scores. Therefore, the # of patients analyzed for the combined daily symptom score can vary from the #s for individual day & night scores. (NCT01709864)
Timeframe: 12 weeks

,
Interventionscore (Least Squares Mean)
Daytime total symptom score (n=208,202)nighttime total symptom score (n=207,202)
NVA237-1.14-1.22
Placebo-0.73-0.95

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"Percentage of Days Able to Perform Usual Daily Activities"

"Patients are reporting symptoms by using an electronic diary. A day able to perform usual daily activities is defined from diary data as any day where the patient was not prevented from performing their usual daily activities due to respiratory symptoms." (NCT01709864)
Timeframe: from Baseline up to 12 weeks

Interventionpecentage of days (Least Squares Mean)
NVA2378.6
Placebo1.8

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Change From Baseline of Daily Symptom Scores

Patients reported symptoms using an electronic diary.The diary has 9 symptom questions each am and each pm. Each question can be answered w/1 of 4 pre-defined answers, with a unit value of 0-3, 0 is least & 3 is most severe symptom.Symptom scores are calculated as the mean of combined daily symptom scores(combined from am & pm)for each patient over 12 weeks. The baseline is calculated from the run-in epoch prior to randomization.The change from baseline is in LS mean daily symptom scores over the 12 weeks. If the mean score over the 12 weeks is lower than the baseline, result is (-).A neg. result indicates an improvement in COPD symptom severity. Patients may have met the min. response requirements for the night scores(am questions),but not for the day scores(pm questions)or vice versa, the # of patients analyzed can vary between both day & night scores. Therefore, the # of patients analyzed for the combined daily symptom score can vary from the #s for individual day & night scores. (NCT01709864)
Timeframe: 12 weeks

InterventionScore (Least Squares Mean)
NVA237-1.39
Placebo-1.01

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"Percentage of Nights With no Nighttime Awakenings"

"Patients are reporting symptoms by using an electronic diary. A night with no nighttime awakening is defined from diary data as any night where the patient did not wake up due to symptoms. Percentage of no nighttime awakenings from Baseline up to 12 weeks." (NCT01709864)
Timeframe: from Baseline up to 12 weeks

Interventionpercentage of nights (Least Squares Mean)
NVA23713.3
Placebo11.3

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"Percentage of Days With no Daytime Symptoms"

"Patients are reporting symptoms by using an electronic diary. A day with no daytime symptoms is defined from diary data as any day where the patient has recorded in the evening no cough, no wheeze, no production of sputum, and no feeling of breathlessness (other than when running) during the past approximately 12 hours. The percentage of days is calculated by the number of days with no daytime symptoms/total number of days with evaluable data X 100." (NCT01709864)
Timeframe: from Baseline up to 12 weeks

Interventionpercentage of days (Least Squares Mean)
NVA2375.1
Placebo2.5

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Breathlessness Assessed by Transition Dyspnea Index (TDI) Focal Score at Week 12

Breathlessness at week 12 is measured using the Transition Dyspnea Index (TDI). On day 1, breathlessness is assessed by the Baseline Dyspnea Index (BDI). Patients are considered to have clinically significant improvement with the TDI score change versus BDI being equal to or greater than 1. TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort. Each domain is scored from -3 (major deterioration) to 3 (major improvement) to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. (NCT01709864)
Timeframe: Week 12

Interventionscores on a scale (Least Squares Mean)
NVA2371.46
Placebo0.54

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Change From Baseline in the Health Status Assessed by St. George's Respiratory Questionnaire

The health status, as reported by the patients, is assessed using the St. George's Respiratory Questionnaire (SGRQ). The SGRQ is a 50 item scale assessing symptoms, patient activities and impact of the disease. Scores range from 0 to 100 units, with higher scores indicating more limitations. The assessment is based on total score as well as the percentage of patients with clinically significant improvement at week 12 versus day 1. A clinically meaningful improvement (MCID) in SGRQ is defined as a decrease of 4 or more units of the SGRQ scale in the total score, as compared to baseline (change from baseline). (NCT01709864)
Timeframe: Week 12

Interventionscore (Least Squares Mean)
NVA237-4.4
Placebo-1.7

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Change From Baseline of Forced Vital Capacity (FVC) at All Individual Timepoints at Day 1 and at Week 12 (Day 85)

The Forced Vital Capacity (FVC) assessments for all individual time points of the serial measurements on day 1 and at week 12 are analyzed. (NCT01709864)
Timeframe: Baseline, Day 1 and Week 12 (Day 85)

,
Interventionliters (Least Squares Mean)
DAY 1/ 5 min (n=221, 214)DAY 1/ 15 min (n=222, 216)DAY 1/ 1h (n=222, 216)DAY 1/ 2h (n=221, 216)DAY 1/ 4h (n=220, 213)DAY 1/ 6h (n=221, 214)DAY 1/ 8h (n=220, 214)DAY 1/ 11h 55min (n=216, 207)DAY 85/ -45 min (n=217, 208)DAY 85/ -15 min (n=216, 208)DAY 85/ 5 min (n=221, 214)DAY 85/ 15 min (n=222, 216)DAY 85/ 1h (n=222, 216)DAY 85/ 2h (n=221, 216)DAY 85/ 4h (n=220, 213)DAY 85/ 6h (n=221, 214)DAY 85/ 8h (n=220, 214)DAY 85/ 11h 55min (n=216, 207)
NVA2370.1750.2650.3180.3510.2900.2520.1920.1520.1620.1560.1840.2630.2580.2770.2150.1990.1280.110
Placebo0.0370.0440.0320.0710.0670.022-0.009-0.030-0.043-0.017-0.007-0.0030.0040.0330.076-0.015-0.023-0.006

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Change From Baseline of Forced Expiratory Volume in One Second (FEV1) at All Individual Timepoints at Day 1 and at Week 12 (Day 85)

The Forced Expiratory Volume in one second (FEV1) assessments for all individual time points of the serial measurements on day 1 and at week 12 are analyzed. (NCT01709864)
Timeframe: Baseline, Day 1 and Week 12 (Day 85)

,
Interventionliters (Least Squares Mean)
DAY 1/ 5 min (n=221, 214)DAY 1/ 15 min (n=222, 216)DAY 1/ 1h (n=222, 216)DAY 1/ 2h (n=221, 216)DAY 1/ 4h (n=220, 213)DAY 1/ 6h (n=221, 214)DAY 1/ 8h (n=220, 214)DAY 1/ 11h 55min (n=216, 207)DAY 85/ -45 min (n=217, 208)DAY 85/ -15 min (n=216, 208)DAY 85/ 5 min (n=221, 214)DAY 85/ 15 min (n=222, 216)DAY 85/ 1h (n=222, 216)DAY 85/ 2h (n=221, 216)DAY 85/ 4h (n=220, 213)DAY 85/ 6h (n=221, 214)DAY 85/ 8h (n=220, 214)DAY 85/ 11h 55min (n=216, 207)
NVA2370.0740.1290.1760.1980.1680.1320.1130.0830.0920.0900.1180.1710.1780.1860.1470.1200.0800.072
Placebo0.0150.0150.0080.0310.0280.000-0.022-0.046-0.040-0.022-0.018-0.016-0.0140.0060.014-0.026-0.036-0.043

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Change From Baseline in Trough FEV1 and Pre-dose Trough FEV1 by Visit

Trough Forced Expiratory Volume in one second (FEV1) is the mean of FEV1 at 23h 15min and 23h 45min after the morning dose of the previous day. Pre-dose trough FEV1 is the mean of FEV1 at -45min and -15min before morning dose (NCT01709864)
Timeframe: Day 2, 86 (trough) Day 15, 29, 57, 85 (pre-dose trough)

,
Interventionliters (Least Squares Mean)
Trough FEV1 Day 2 (n=218, n=214)Trough FEV1 Day 86 (n=218, n=214)Pre-dose Trough FEV1 Day 15 (n=217, n=208)Pre-dose Trough FEV1 Day 29 (n=217, n=208)Pre-dose Trough FEV1 Day 57 (n=217, n=208)Pre-dose Trough FEV1 Day 85 (n=217, n=208)
NVA2370.1410.1230.1120.01050.01060.090
Placebo0.0250.007-0.002-0.005-0.006-0.029

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Change From Baseline in FEV1 AUC (0-12H) at Day 1 and FEV1 AUC (0-4h), AUC (4-8h), AUC (8-12h) at Day 1 and Week 12 (Day 85)

The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) is assessed for different time spans within the overall serial measurement post dosing (FEV1 AUCs Time Spans), at day 1 and at week 12 of treatment. Serial lung function measurements are taken at various time points post dosing on day 1 and at week 12 to calculate the AUC for these different time spans. (NCT01709864)
Timeframe: Day 1 and Week 12 (Day 85)

,
Interventionliters*hr (Least Squares Mean)
FEV1, AUC 0-12h Day 1 (n=222, n=216)FEV1, AUC 0-4h Day 1 (n=222, n=216)FEV1, AUC 0-4h Day 85 (n=222, n=216)FEV1, AUC 4-8h Day 1 (n=222, n=215)FEV1, AUC 4-8h Day 85 (n=222, n=215)FEV1, AUC 8-12h Day 1 (n=222, n=215)FEV1, AUC 8-12h Day 85 (n=222, n=215)
NVA2370.1400.1740.1710.1380.1150.1020.074
Placebo-0.0010.0210.0010.001-0.017-0.037-0.034

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The Average Number of Puffs of Rescue Medication Per Day

Patients report the number of puffs of rescue medication (salbutamol / albuterol) using an electronic diary. The use of rescue medication is analyzed as the mean daily number of puffs used per patient over the 12 weeks treatment period. (NCT01709864)
Timeframe: baseline and 12 weeks

Interventionnumber of puffs (Least Squares Mean)
NVA237-1.63
Placebo-0.86

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Percentage of Participants With a Clinically Important Improvement of >=4units in the SGRQ Total Score at Week 12

The health status, as reported by the patients, is assessed using the St. George's Respiratory Questionnaire (SGRQ). The assessment is based on total score as well as the percentage of patients with clinically significant improvement at week 12 versus day 1. A clinically significant improvement in SGRQ is defined as less than or equal to -4 change from baseline. (NCT01709864)
Timeframe: Week 12

Interventionpercentage of participants (Number)
NVA23749.0
Placebo40.6

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Percentage of Days Without Rescue Medication Use

Patients report the number of puffs of rescue medication (salbutamol / albuterol) using an electronic diary. The use of rescue medication is analyzed as the percentage of days without usage of rescue medication over the 12 weeks treatment period. The baseline is calculated from the run-in epoch prior to randomization. (NCT01709864)
Timeframe: 12 weeks

Interventionpercentage of days (Least Squares Mean)
NVA23716.6
Placebo10.5

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Change From Baseline of Standardized Area Under the Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) Post Dosing

The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) post dosing (FEV1 AUC) at week 12 of treatment. Serial lung function measurements are taken at various time points following dosing at week 12 to calculate the AUC. (NCT01709864)
Timeframe: 12 weeks

Interventionliters*hr (Least Squares Mean)
NVA2370.125
Placebo-0.014

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Analysis of FEV1 (L) Trough Response (Pre-dose) Over the Whole Treatment Period

Average of Trough Forced Expiratory Volume in one second (FEV1) (NCT01709903)
Timeframe: 6,12,18 and 26 weeks

,
Interventionliter (Least Squares Mean)
Week 6 (n=356,341)week 12 (n=346,333)week 18 (n=339,332)week 26 (n=338,324)
Fluticasone/Salmeterol1.1841.1911.1741.142
QVA1491.2561.2651.2521.226

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Trough Forced Expiratory Volume in One Second (FEV1) Following 26 Weeks of Treatment to Demonstrate the Superiority of QVA 110/50μg o.d. to Fluticasone/Salmeterol 500/50 μg b.i.d

(NCT01709903)
Timeframe: 26 weeks

Interventionliters (Least Squares Mean)
QVA1491.259
Fluticasone/Salmeterol1.183

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Trough Forced Expiratory Volume in One Second (FEV1) Following 26 Weeks of Treatment to Demonstrate the Non-inferiority of QVA149 110/50 μg o.d. to Fluticasone/Salmeterol 500/50 μg b.i.d

Measurement of QVA149 110/50 μg o.d. to fluticasone/salmeterol 500/50 μg b.i.d. in terms of trough FEV1 (mean of 23 h 15 min and 23 h 45 min post QVA149 dose) following 26 weeks of treatment in patients with moderate to severe COPD. (NCT01709903)
Timeframe: 26 weeks

Interventionliters (Least Squares Mean)
QVA1491.248
Fluticasone/Salmeterol1.176

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Analysis of the TDI Focal Score Over the Whole Treatment Period

"The Transition Dyspnea Index (TDI) total score after 12 and 26 weeks of treatment will be analyzed using the same mixed model as specified for the primary analysis with the Baseline Dyspnea Index (BDI) total score as the baseline.Total score ranging - 9 to + 9. The lower the score, the more deterioration in severity of dyspnea. One additional option in each category, which does not contribute to the score, allows for circumstances in which impairment is due to reasons other than dyspnea. .Baseline 12 weeks and Baseline 26 weeks, were the baseline scores for available participants analyzed for each time point." (NCT01709903)
Timeframe: 12 and 26 weeks

,
InterventionNumbers on a scale (Least Squares Mean)
Baseline 12 weeks (n=348,337)12 weeks (n=348,337)Baseline 26 weeks (n=335,326)26 weeks (n=335,326)
Fluticasone/Salmeterol6.362.406.402.86
QVA1496.362.626.383.02

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Symptoms Reported Using E-diary Over 12 and 26 Weeks of Treatment

Percentage of nights with 'no nighttime awakenings', percentage of days with 'no daytime symptoms', and percentage of 'days able to perform usual daily activities' over 26 weeks (FAS) (NCT01709903)
Timeframe: 26 weeks

,
Intervention% days in study (Least Squares Mean)
% nights 'no nighttime awakenings' (n=336,322)% days with 'no daytime symptoms' (n=341,334)% days able perform daily activities (n=341,334)
Fluticasone/Salmeterol67.8610.2242.16
QVA14967.577.3144.02

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Rescue Medication Use: Summary of the Mean Daily, Daytime and Nighttime Number of Puffs of Rescue Medication, by 4 Weekly Intervals

"The number of puffs of rescue medication taken in the previous 12 hours will be recorded in the Patient Diary in the morning and evening. Baseline 12 weeks and Baseline 26 weeks, were the baseline scores for available participants analyzed for each time point. Less puffs taken is better." (NCT01709903)
Timeframe: 12 and 26 weeks

,
Intervention# of puffs (Mean)
Baseline Daytime 12-16 weeks (n=329,318)Daytime 12-16 weeks (n=329,318)Baseline Nighttime 12-16 weeks (n=322,307)Nighttime 12-16 weeks (n=322,307)Baseline Daytime 24-26 weeks (n=326,315)Daytime 24-26 weeks (n=326,315)Baseline Night time 24-26 weeks (n=320,304)Night time 24-26 weeks (n=320,304)
Fluticasone/Salmeterol1.690.611.240.491.700.621.210.48
QVA1491.570.661.250.521.540.631.230.52

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Analysis of Trough FVC (L) Over the Whole Treatment Period

Average of Trough Forced Vital Capacity (FVC) at 23 hours 15 min and the 23 hours 45 min post dose (NCT01709903)
Timeframe: 12 and 26 weeks

,
Interventionliter (Least Squares Mean)
Day 1 (n=350,351)Week 12 (n=342,332)week 26 (n= 333,323)
Fluticasone/Salmeterol2.9572.8352.793
QVA1493.0403.0362.966

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Standardized Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC) 0-4 Hours

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 1 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country. (NCT01709903)
Timeframe: Day 1, 12 and 26 weeks

,
InterventionLiter (Mean)
Day 1 (n=369,364)12 weeks (n=350,338)26 weeks (n=339,323)
Fluticasone/Salmeterol1.2521.2621.229
QVA1491.3171.3881.351

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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." (NCT01712516)
Timeframe: 12 weeks

InterventionPercentage of participants (Number)
QVA14959.2
QAB14956.8
NVA23751.5
Placebo34.5

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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. (NCT01712516)
Timeframe: BL, day 1, 12 weeks

,,,
InterventionLiters (Least Squares Mean)
Day 1, AUC 0-4h (n=249,251,250,246)Day 1, AUC 4-8h (n=248,248,250,243)Day 1, AUC 8-12h (n=248,249,249,245)Day 1, AUC 0-12h (n=249,251,250,246)Week 12, AUC 0-4h (n=249,251,250,246)Week 12, AUC 4-8h (n=248,248,250,243)Week 12, AUC 8-12h (n=248,249,249,245)Week 12, AUC 0-12h (n=249,251,250,246)
NVA2370.1740.1340.0920.1350.1960.1480.1230.155
Placebo0.019-0.003-0.031-0.003-0.008-0.021-0.055-0.028
QAB1490.1010.0900.0540.0800.1470.1200.0950.122
QVA1490.2130.1870.1430.1840.2890.2290.1820.234

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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. (NCT01712516)
Timeframe: BL, 12 weeks

,,,
Interventionscore on a scale (Least Squares Mean)
total daily (n=243,242,242,235)total daytime (n=242,239,240,234)total nighttime (n=243,239,238,234)
NVA237-1.09-0.96-0.90
Placebo-0.61-0.53-0.41
QAB149-1.22-1.05-1.01
QVA149-1.34-1.16-1.09

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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." (NCT01712516)
Timeframe: BL, 12 Weeks

Interventionscore on a scale (Least Squares Mean)
QVA149-7.5
QAB149-5.9
NVA237-6.0
Placebo-1.1

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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. (NCT01712516)
Timeframe: BL, day 85

InterventionLiters (Least Squares Mean)
QVA1490.193
QAB1490.100
NVA2370.108
Placebo-0.027

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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. (NCT01712516)
Timeframe: BL, 12 weeks

Interventionnumber of puffs (Least Squares Mean)
QVA149-2.19
QAB149-2.05
NVA237-1.78
Placebo-1.04

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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. (NCT01712516)
Timeframe: 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; day 86: 23h15min; 23h45min

,,,
InterventionLiters (Least Squares Mean)
day 1, 5 min (n=248,249,249,243)day 1, 15 min (n=248,251,249,244)day 1, 1 h (n=249,251,249,246)day 1, 2 h (n=249,249,248,246)day 1, 4 h (n=247,247,248,237)day 1, 6 h (n=247,246,244,239)day 1, 8 h (n=248,247,245,242)day 1, 11 h 55 min(n=242,243,244,239)day 2, 23 h 15 min (n=241,246,245,241)day 2, 23 h 45 min (n= 246,251,248,244)day 15, - 45 min (243,249,246,240)day 15, -15 min (n=243,248,246,241)day 15, 1 h (n=249,251,249,246)day 29, -45 min (n=243,249,246,240)day 29, -15 min (n=243,248,246,241)day 29, 1 h (n=249,251,249,246)day 57, -45 min (n=243,249,246,240)day 57, -15 min (n=243,248,246,241)day 57, 1 h (n=249,251,249,246)day 85, -45 min (n=243,249,246,240)day 85, - 15 min (n=243,248,246,241)day 85, 5 min (n=248,249,249,243)day 85, 15 min (n=248,251,249,244)day 85, 1 h (n=249,251,249,246)day 85, 2 h (n=249,249,248,246)day 85, 4 h (n=247,247,248,237)day 85, 6 h (n=247,246,244,239)day 85, 8 h (n=248,247,245,242)day 85, 11 h 55 min(n=242,243,244,239)day 86, 23 h 15 min (n=241,246,245,241)day 86, 23 h 45 min (n=246,251,248,244)
NVA2370.0720.1260.1760.1970.1670.1350.1120.0660.1280.1370.1080.1320.2120.1170.1380.2160.1170.1470.2210.0960.1230.1430.1790.2080.2160.1720.1390.1330.1050.1170.132
Placebo-0.0010.0050.0080.0300.019-0.005-0.019-0.0450.0020.018-0.045-0.025-0.019-0.030-0.013-0.004-0.037-0.014-0.016-0.032-0.018-0.020-0.001-0.018-0.001-0.004-0.011-0.039-0.073-0.023-0.012
QAB1490.0760.0900.0890.1090.1080.0850.0770.0290.1050.1180.1140.1430.1790.1270.1470.1700.1040.1250.1630.0900.1090.1510.1530.1410.1590.1450.1220.1070.0780.1300.144
QVA1490.1170.1600.1990.2370.2200.1810.1650.1160.2010.2160.2080.2380.3210.2130.2350.3200.2030.2240.3190.1870.1990.2460.2690.2930.3150.2600.2260.1980.1630.2060.221

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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. (NCT01712516)
Timeframe: 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; day 86: 23h15min; 23h45min

,,,
InterventionLiters (Least Squares Mean)
day 1, 5 min (n=248,249,249,243)day 1, 15 min (n=248,251,249,244)day 1, 1 h (n=249,251,249,246)day 1, 2 h (n=249,249,248,246)day 1, 4 h (n=247,247,248,237)day 1, 6 h (n=247,246,244,239)day 1, 8 h (n=248,247,245,242)day 1, 11 h 55 min (n=242,243,244,239)day 2, 23 h 15 min (n=241,246,245,241)day 2, 23 h 45 min (n=246,251,248,244)day 15, -45 min (n=243,249,246,240)day 15, -15 min (n=243,248,246,241)day 15, 1 h (n=249,251,249,246)day 29, -45 min (n=243,249,246,240)day 29, -15 min (n=243,248,246,241)day 29, 1 h (n=249,251,249,246)day 57, -45 min (n=243,249,246,240)day 57, -15 min (n=243,248,246,241)day 57, 1 h (n=249,251,249,246)day 85, -45 min (n=243,249,246,240)day 85, -15 min (n=243,248,246,241)day 85, 5 min (n=248,249,249,243)day 85, 15 min (n=248,251,249,244)day 85, 1 h (n=249,251,249,246)day 85, 2h (n=249,249,248,246)day 85, 4 h (n=247,247,248,237)day 85, 6 h (n=247,246,244,239)day 85, 8 h (n=248,247,245,242)day 85, 11 55 min (n=242,243,244,239)day 86, 23 h 15 min (n=241,246,245,241)day 86, 23 h 45 min (n=246,251,248,244)
NVA2370.1580.2380.3090.3240.2710.2440.2120.1250.2170.2290.1680.1980.3110.1880.1970.3220.1730.2220.3260.1430.1800.2250.2760.2950.3010.2610.2110.2130.1970.1760.210
Placebo-0.0060.0090.0130.0440.0260.004-0.021-0.0600.0010.027-0.047-0.020-0.009-0.025-0.0040.008-0.034-0.009-0.011-0.029-0.031-0.048-0.004-0.023-0.0010.002-0.011-0.038-0.093-0.021-0.017
QAB1490.1750.1850.1530.2140.1890.1590.1540.0930.1910.1960.1630.2010.2690.1940.2180.2590.1420.1670.2270.1210.1420.2150.2230.2090.2180.2030.1640.1520.1310.1720.199
QVA1490.2450.3180.3550.3950.3640.3160.2850.2350.3430.3550.3130.3580.4730.3200.3320.4490.2930.2980.4450.2520.2630.3310.3770.4000.4140.3380.3050.2730.2330.2780.298

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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. (NCT01712516)
Timeframe: BL, 12 weeks

Interventionscore on a scale (Least Squares Mean)
QVA1492.88
QAB1491.98
NVA2371.88
Placebo0.85

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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. (NCT01712516)
Timeframe: BL, day 2, day 86

,,,
InterventionLiters (Least Squares Mean)
day 2day 86
NVA2370.1320.128
Placebo0.010-0.017
QAB1490.1110.138
QVA1490.2080.216

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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. (NCT01712516)
Timeframe: baseline (BL), 12 weeks

InterventionLiters (Least Squares Mean)
QVA1490.234
QAB1490.122
NVA2370.155
Placebo-0.028

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Change From Baseline in Standardized Area Under The Curve for Forced Expiratory Volume in One Second for Different Time Spans Post Dosing

"The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1FEV1) is assessed for different time spans (0-4 h, 4-8 h, 8-12 h) within the overall serial measurement post dosing (FEV1 AUCs Time Spans), at day 1 and at week 12 of treatment. Serial lung function measurements are taken at various the following time points post dosing on day 1 and at week 12 to calculate the FEV1 AUC for these different time spans: .5 min, 15 min, 1:00 h, 2:00 h, 4:00 h, 6:00 h, 8:00 h, and 11:55 h after the morning dose.~The endpoint was the change from baseline (CFB) in FEV1 AUC0-12h following the morning dose at day 1 or week 12, respectively, (defined as the mean FEV1 change from baseline over 5 min to 11 h 55 mins divided by 11 h 50 mins). Where the FEV1 AUC is smaller than at baseline, a negative value can occur." (NCT01715298)
Timeframe: Day 1 and Week 12

,
InterventionLiters (Least Squares Mean)
Day 1 AUC 0-4h (n=215,213)Week 12 AUC 0-4h (n=215,213)Day 1 AUC 4-8h (n=213,209)Week 12 AUC 4-8h (n=213,209)Day 1 AUC 8-12h (n=212,210)Week 12 AUC 8-12h (n=212,210)
NVA2370.1540.1530.1180.1070.0850.075
Placebo0.0140.0040.0110.000-0.021-0.033

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Change From Baseline in Morning and Nighttime Symptom Scores

Patients are reporting morning and nighttime symptoms by using an electronic diary. The electronic diary has 9 symptom questions each morning and each evening. Each question can be answered with one of four pre-defined answers, corresponding to a unit value of 0-3, where 0 stands for the lowest and 3 for the most severe symptom experience. Morning and nighttime symptoms scores for each patient over 12 weeks are reported and analyzed. Symptom scores are calculated as the mean of the symptom scores (morning symptom scores or nighttime symptom scores, respectively) for each patient over 12 weeks (Day 1 to week 12). The baseline is calculated from the run-in epoch prior to randomization. The outcome is calculated as the change from baseline in the morning and nighttime symptom scores, respectively. A negative number indicates a reduction in the symptom severity and is owed to the calculation of the change from baseline. (NCT01715298)
Timeframe: Day 1 to week 12

,
InterventionScore (Least Squares Mean)
Daytime total symptom score (n=207,195)Nighttime total symptom score (n=208,200)
NVA237-0.86-1.03
Placebo-0.61-0.76

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Change From Baseline in Mean Trough Forced Vital Capacity

Mean trough Forced Vital Capacity (FVC) is assessed as the arithmetic mean of two FVC measurements, conducted within the last hour of a 24 hours period from a morning dose, either that of day 1 or at week 12 of treatment (23:15 h and 23:45 h assessments). The endpoints are the change from baseline in trough FVC on Day 1 and at Week 12, with the mean of the -45 min and -15 min measurements on Day 1 as the baseline. (NCT01715298)
Timeframe: Day 1 and week 12

,
InterventionLiters (Least Squares Mean)
Day 1Week 12
NVA2370.2490.210
Placebo0.0780.080

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Change From Baseline in Forced Vital Capacity at All Individual Timepoints

The Forced Vital Capacity (FVC)assessments for all individual time points of the serial measurements on day 1 and at week 12 are analyzed. Serial lung function measurements are taken at the following time points following dosing on Day 1 and at week 12: 5 min, 15 min, 1:00 h, 2:00 h, 4:00 h, 6:00 h, 8:00 h, and 11:55 h after the morning dose. For week 12 (day 85), the pre-dose measurements (-45 min and -15 min) and the trough measurements (23:15 h and 23:45 h post-dose) are included. The endpoints are the change from baseline in FVC following the morning dose on Day 1 and at Week 12. Where the FVC at any one timepoint is smaller than at baseline, a negative value can occur. (NCT01715298)
Timeframe: Day 1 and week 12

,
InterventionLiters (Least Squares Mean)
FVC, day 1, 5 min (n=214,211)FVC, day 1, 15 min (n=214,213)FVC, day 1, 1 h (n=215,211)FVC, day 1, 2 h (n=211,211)FVC, day 1, 4 h (n=209,208)FVC, day 1, 6 h (n=208,205)FVC, day 1, 8 h (n=209,205)FVC, day 1, 11 h 55min (n=203,202)FVC, day 85, -45 min (n=207,204)FVC, day 85, -15 min (n=208,204)FVC, day 85, 5 min (n=214,211)FVC, day 85, 15 min (n=214,213)FVC, day 85, 1 hr (n=215,211)FVC, day 85, 2 hr (n=211,211)FVC, day 85, 4 hr (n=209,208)FVC, day 85, 6 hr (n=208,205)FVC, day 85, 8 hr (n=209,205)FVC, day 85, 11 hr 55min (n=203,202)FVC, day 85, 23 hr 15min (n=210,204)FVC, day 85, 23 hr 45min (n=213,208)
NVA2370.1200.2330.3040.3220.2470.2250.2000.1470.1230.1460.1770.2190.2670.2750.2040.1850.1520.1350.2070.228
Placebo-0.0140.0050.0410.0600.0480.051-0.002-0.0170.0080.0100.001-0.0030.0100.0240.0350.016-0.015-0.0450.0660.095

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Change From Baseline in Forced Expiratory Volume in One Second at All Individual Timepoints

The Forced Expiratory Volume in one second (FEV1) assessments for all individual time points of the serial measurements on day 1 and at week 12 are analyzed. Time points of the serial lung function measurements are 5 min, 15 min, 1:00 h, 2:00 h, 4:00 h, 6:00 h, 8:00 h, and 11:55 h after the morning dose. The table indicates the percent change from baseline (CFB) in FEV1 and standard deviation in brackets. Where the FEV1 is lower than at baseline, a negative percent value can occur. (NCT01715298)
Timeframe: Day 1 and week 12

,
InterventionPercent (Mean)
FEV1, day 1, 5 min (n=207,202)FEV1, day 1, 15 min (n=209,201)FEV1, day 1, 1 h (n=205,205)FEV1, day 1, 2 h (n=201,205)FEV1, day 1, 4 h (n=199,202)FEV1, day 1, 6h (n=197,197)FEV1, day 1, 8 h (n=200,189)FEV1, day 1, 11 h 55min (n=184,182)FEV1, day 85, -45min (n=184,188)FEV1, day 85, -15min (n=180,185)FEV1, day 85, 5min (n=185,178)FEV1, day 85, 15min (n=186,189)FEV1, day 85, 1h (n=184,187)FEV1, day 85, 2h (n=178,187)FEV1, day 85, 4h (n=179,183)FEV1, day 85, 6h (n=174,172)FEV1, day 85, 8h (n=178,174)FEV1, day 85, 11h 55min (n=171,171)
NVA2374.99.913.916.012.710.38.96.66.49.610.412.915.816.012.59.87.87.2
Placebo-0.30.31.22.52.22.2-0.5-1.71.72.71.82.01.62.43.52.50.2-2.1

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Change From Baseline in the Percentage of Days Without Rescue Medication Use

Patients report the number of puffs of rescue medication (salbutamol / albuterol) using an electronic diary. The use of rescue medication is analyzed as the change from baseline in the percentage of days without usage of rescue medication over the 12 weeks treatment period. The baseline is calculated as the percentage of days without usage of rescue medication from during the the run-in epoch prior to randomization. (NCT01715298)
Timeframe: Baseline and week 12

Interventionpercentage of days (Least Squares Mean)
NVA23711.4
Placebo7.0

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Change From Baseline in the Health Status Assessed by St. George's Respiratory Questionnaire

The health status, as reported by the patients, is assessed using the St. George's Respiratory Questionnaire (SGRQ). The SGRQ is a 50 item scale assessing symptoms, patient activities and impact of the disease. Scores range from 0 to 100 units, with higher scores indicating more limitations. The assessment is based on total score as well as the percentage of patients with clinically significant improvement at week 12 versus day 1. A clinically meaningful improvement (MCID) in SGRQ is defined as a decrease of 4 or more units of the SGRQ scale in the total score, as compared to baseline (change from baseline). (NCT01715298)
Timeframe: Week 12

InterventionScore (Least Squares Mean)
NVA237-6.4
Placebo-1.2

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Change From Baseline in Standardized Area Under the Curve for Forced Expiratory Volume in One Second Post Dosing

"The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) post dosing (FEV1 AUC) is measured at week 12 of treatment. Serial lung function measurements are taken at the following time points following dosing at week 12 to calculate the FEV1 AUC: 5 min, 15 min, 1:00 h, 2:00 h, 4:00 h, 6:00 h, 8:00 h, and 11:55 h after the morning dose.~The primary endpoint was the change from baseline in FEV1 AUC0-12h following the morning dose at Week 12 (defined as the mean FEV1 change from baseline (CFB) over 5 min to 11 h 55 mins divided by 11 h 50 mins). Where the FEV1 AUC is smaller than at baseline, a negative value can occur" (NCT01715298)
Timeframe: Week 12

InterventionLiters (Least Squares Mean)
NVA2370.115
Placebo-0.008

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Change From Baseline in Standardized Area Under the Curve (AUC(0-12h)) for Forced Expiratory Volume in One Second Post Dosing

"The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) post dosing (FEV1 AUC) is assessed at day 1 of treatment. Serial lung function measurements are taken at the following various time points post dosing at day 1 to calculate the FEV1 AUC: 5 min, 15 min, 1:00 h, 2:00 h, 4:00 h, 6:00 h, 8:00 h, and 11:55 h after the morning dose.~.The endpoint was the change from baseline (CFB) in FEV1 AUC0-12h following the morning dose at day 1 (defined as the mean FEV1 change from baseline over 5 min to 11 h 55 mins divided by 11 h 50 mins). Where the FEV1 AUC is smaller than at baseline, a negative value can occur." (NCT01715298)
Timeframe: Day 1

InterventionLiters (Least Squares Mean)
NVA2370.121
Placebo0.003

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Change From Baseline in Mean Number of Puffs of Rescue Medication Per Day

Patients report the number of puffs of rescue medication (salbutamol / albuterol) using an electronic diary. The use of rescue medication is analyzed as the change from baseline in the mean daily number of puffs used per patient over the 12 weeks treatment period. The baseline is calculated from the run-in epoch prior to randomization (mean number of puffs per day). A negative number indicates a reduction in the mean daily number of puffs of rescue medication. (NCT01715298)
Timeframe: Baseline and week 12

InterventionNumber of puffs (Least Squares Mean)
NVA237-1.33
Placebo-0.80

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Change From Baseline in Daily Symptom Scores

Patients are reporting symptoms by using an electronic diary. The electronic diary has 9 symptom questions each morning and each evening. Each question can be answered with one of four pre-defined answers, corresponding to a unit value of 0-3, where 0 stands for the lowest and 3 for the most severe symptom experience. Symptom scores are calculated as the mean of the combined daily symptom scores (combined from morning and evening scores) for each patient over 12 weeks (Day 1 to week 12). The baseline is calculated from the run-in epoch prior to randomization. The change from baseline in the least squares mean daily symptom scores over the 12 week treatment period is provided. Where the mean daily symptom score over the 12 week treatment period is lower than the baseline, the result is negative. A negative result indicates an improvement in COPD symptom severity. (NCT01715298)
Timeframe: day 1 to week 12

InterventionScore (Least Squares Mean)
NVA237-1.09
Placebo-0.80

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Breathlessness Assessed by Transition Dyspnea Index

Breathlessness at week 12 is measured using the interviewer-administered Transition Dyspnea Index (TDI). On day 1, breathlessness is assessed by the interviewer-administered Baseline Dyspnea Index (BDI). The change from BDI to TDI is assessed, with the TDI total score ranging from -9 to +9 units of the scale. The lower the score, the more deterioration in severity of dyspnea. Patients are considered to have clinically significant improvement (MCID) with the TDI score change versus BDI being equal to or greater than 1. (NCT01715298)
Timeframe: Week 12

InterventionScore (Least Squares Mean)
NVA2370.95
Placebo0.48

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"Change From Baseline in the Percentage of Nights With no Nighttime Awakenings"

"Patients are reporting symptoms by using an electronic diary. The electronic diary has 9 symptom questions each morning and each evening. One of the symptom questions of the morning questionnaire relates to the number of awakenings due to COPD symptoms during the previous night. The answer with the lowest symptom score is no waking due to symptoms. A night with no nighttime awakening is defined from diary data as any night where the patient did not wake up due to symptoms. The change from baseline in the percentage of nights with no nighttime awakening is calculated from the mean percentage of nights with this answer over the 12 week treatment period, with the baseline being The baseline is calculated from the run-in epoch prior to randomization." (NCT01715298)
Timeframe: Day 1 and week 12

InterventionPercentage of nights (Least Squares Mean)
NVA23713.1
Placebo9.2

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"Change From Baseline in the Percentage of Days With no Daytime Symptoms"

"Patients are reporting symptoms by using an electronic diary. The electronic diary has 9 symptom questions each morning and each evening. Each question can be answered with one of four pre-defined answers, corresponding to a unit value of 0-3, where 0 stands for the lowest and 3 for the most severe symptom experience. A day with no daytime symptoms is defined from diary data as any day where the patient has recorded in the evening no cough, no wheeze, no production of sputum, and no feeling of breathlessness (other than when running) during the past approximately 12 hours in the evening questionnaire. The change from baseline in the percentage of days with no daytime symptoms is calculated from the mean percentage of days with this answer over the 12 week treatment period, with the baseline being. The baseline is calculated from the run-in epoch prior to randomization." (NCT01715298)
Timeframe: Day 1 to week 12

InterventionPercentage of days (Least Squares Mean)
NVA2373.6
Placebo2.6

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"Change From Baseline in Percentage of Days Able to Perform Usual Daily Activities"

"Patients are reporting symptoms by using an electronic diary. The electronic diary has 9 symptom questions each morning and each evening. One of the symptom questions of the evening questionnaire relates to the impact of COPD symptoms on the performance of usual daily activities (Did your respiratory symptoms stop you performing your usual daily activities today). The answer with the lowest symptom score is not at all. A day able to perform usual daily activities is defined from diary data as any day where the patient was not prevented from performing their usual daily activities due to respiratory symptoms. The change from baseline in the percentage of days able to perform usual daily activities is calculated from the mean percentage of days with this answer over the 12 week treatment period, with the baseline beingThe baseline is calculated from the run-in epoch prior to randomization." (NCT01715298)
Timeframe: Day 1 to week 12

InterventionPercentage of days (Least Squares Mean)
NVA2375.2
Placebo0.9

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Mean Trough Forced Expiratory Volume in One Second

Mean trough Forced Expiratory Volume in one second (FEV1) is assessed as the arithmetic mean of two FEV1 measurements, conducted within the last hour of a 24 hour period from a morning dose, either that of day 1 or at week 12 of treatment. The data is reported as the change from baseline (CFB), with the baseline being the arithmetic mean of the two pre-dose measurements (-45 min and -15 min) preceding the serial lung function measurements on Day 1 (NCT01715298)
Timeframe: Day 1 and week 12

,
InterventionLiters (Least Squares Mean)
Day 1Week 12
NVA2370.1280.123
Placebo0.0210.038

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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. (NCT01727141)
Timeframe: BL, day 85

InterventionLiters (Least Squares Mean)
QVA1490.161
QAB1490.083
NVA2370.061
Placebo-0.035

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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. (NCT01727141)
Timeframe: BL, 12 Weeks

InterventionNumber of puffs (Least Squares Mean)
QVA149-2.22
QAB149-1.72
NVA237-1.65
Placebo-1.00

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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. (NCT01727141)
Timeframe: BL, day 2, day 86

,,,
InterventionLiters (Least Squares Mean)
day 2day 86
NVA2370.1120.092
Placebo0.015-0.012
QAB1490.1090.120
QVA1490.1870.201

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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. (NCT01727141)
Timeframe: BL, day 1, week 12

,,,
InterventionLiters (Least Squares Mean)
day 1, FEV1 AUC 0-4h (n=249,251,250,246)day 1, FEV1 AUC 4-8h (n=257,260,261,257)day 1, FEV1 AUC 8-12h (n=254,256,259,253)day 1, FEV1 AUC 0-12h (n=249,251,250,246)week 12, FEV1 AUC 0-4h (n=249,251,250,246)week 12, FEV1 AUC 4-8h (n=257,260,261,257)week 12, FEV1 AUC 8-12h (n=254,256,259,253)week 12, FEV1 AUC 0-12h (n=249,251,250,246)
NVA2370.1580.1250.0940.1280.1490.1110.0720.112
Placebo0.0280.023-0.0060.016-0.010-0.016-0.043-0.021
QAB1490.0960.0960.0650.0830.1410.1210.0840.117
QVA1490.1940.1780.1380.1710.2540.2050.1640.211

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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. (NCT01727141)
Timeframe: BL, 12 Weeks

,,,
Interventionscore on a scale (Least Squares Mean)
Daily (n=251,250,252,240)Daytime (n=245,246,245,238)Nighttime (n=244,248,248,234)
NVA237-0.99-0.88-0.85
Placebo-0.52-0.38-0.40
QAB149-0.97-0.85-0.83
QVA149-1.30-1.17-1.07

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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. (NCT01727141)
Timeframe: 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

,,,
InterventionLiters (Least Squares Mean)
Day 1, 5 min (n=255,257,260,255)Day 1, 15 min (n=256,256,261,258)Day 1, 1 h (n=258,260,261,258)Day 1, 2 h (n=254,257,261,254)Day 1, 4 h (n=252,260,256,254)Day 1, 6 h (n=253,256,254,248)Day 1, 8 h (n=253,251,256,248)Day 1, 11 h 55 min(n=246,250,253,245)Day 2, 23 h 15 min (n=249,249,254,242)Day 2, 23 h 45 min (n=255,254,258,250)Day 15, -45 min (n=254,254,256,244)Day 15, -15 min (n=254,254,256,243)Day 15, 1 h (n=258,260,261,258)Day 29, -45 min (n=254,254,256,244)Day 29, -15 min (n=254,254,256,243)Day 29, 1 h (n=258,260,261,258)Day 57, -45 min (n=254,254,256,244)Day 57, -15 min (n=254,254,256,243)Day 57, 1 h (n=258,260,261,258)Day 85, -45 min (n=254,254,256,244)Day 85, -15 min (n=254,254,256,243)Day 85, 5 min (n=255,257,260,255)Day 85, 15 min (n=256,256,261,258)Day 85, 1 h (n=258,260,261,258)Day 85, 2 h (n=254,257,261,254)Day 85, 4 h (n=252,260,256,254)Day 85, 6 h (n=253,256,254,248)Day 85, 8h (n=253,251,256,248)Day 85, 11 55 min (n=246,250,253,245)Day 86, 23 h 15 min (n=249,249,254,242)Day 86, 23 h 45 min (n=255,254,258,250)
NVA2370.1360.2430.2920.3060.2530.2300.1950.1400.1900.2010.1340.1670.2690.1420.1680.2720.1240.1720.2650.0920.1340.1790.2260.2430.2850.2030.1760.1550.1100.1420.167
Placebo0.0090.0320.0290.0760.0720.0430.040-0.0190.0130.056-0.0160.0320.034-0.0220.0170.046-0.0260.0220.030-0.055-0.058-0.031-0.011-0.0240.0120.008-0.033-0.035-0.071-0.0070.029
QAB1490.1750.2000.1910.2200.2090.2140.1880.1220.2140.2320.1880.2060.2740.1770.2030.2590.1530.1770.2390.1060.1290.1920.2260.2000.2220.2010.1640.1540.1090.1600.186
QVA1490.2340.2830.3290.3900.3550.3190.3060.2400.3150.3370.2650.3070.4190.2760.3040.4220.2860.2990.4110.2470.2640.3500.3780.3660.3800.3260.2900.2630.2090.2950.315

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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. (NCT01727141)
Timeframe: 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

,,,
InterventionLiters (Least Squares Mean)
Day 1, 5 min (n=255,257,260,255)Day 1, 15 min (n=256,256,261,258)Day 1, 1 h (n=258,260,261,258)Day 1, 2 h (n=254,257,261,254)Day 1, 4 h (n=252,260,256,254)Day 1, 6 h (n=253,256,254,248)Day 1, 8 h (n=253,251,256,248)Day 1, 11 h (n=246,250,253,245)Day 2, 23h 15 min (n=249,249,254,242)Day 2, 23h 45min (n= 255,254,258,250)Day 15, -45min (n=254,254,256,244)Day 15, -15 min (n=254,254,256,243)Day 15, 1 h (n=258,260,261,258)Day 29, -45 min (n=254,254,256,244)Day 29, -15 min (n=254,254,256,243)Day 29, 1 h (n=258,260, 261,258)Day 57, -45 min (n=254,254,256,244)Day 57, -15 min (n=254,254,256,243)Day 57, 1 h (n=258,260,261,258)Day 85, -45 min (n= 254,254,256,244)Day 85, -15 min (n=254,254,256,243)Day 85, 5 min (n=255,257,260,255)Day 85, 15 min (n=256,256,261,258)Day 85, 1 h (n=258,260,261,258)Day 85, 2 h 9n=254,257,261,254)Day 85, 4 h (n=252,260,256,254)Day 85, 6 h (n=253,256,254,248)Day 85, 8 h (n=253,251,256,248)Day 85, 11 h 55min(n=246,250,253,245)Day 86, 23 h 15 min (n=249,249,254,242)Day 86, 23 h 45 min (n=255,254,258,250)
NVA2370.0650.1170.1660.1790.1460.1250.1060.0730.1060.1190.0670.0870.1610.0730.0920.1560.0690.0940.1610.0510.0730.1060.1300.1500.1710.1320.1090.0860.0550.0820.100
Placebo0.0090.0120.0160.0370.0390.0210.004-0.0200.0040.022-0.023-0.0080.004-0.029-0.0060.006-0.0160.0060.008-0.038-0.035-0.036-0.020-0.021-0.009-0.001-0.017-0.030-0.064-0.017-0.004
QAB1490.0710.0880.0850.1040.1050.1020.0810.0470.1040.1190.1140.1390.1730.1110.1310.1670.0970.1170.1500.0800.0880.1190.1430.1360.1450.1400.1230.1030.0660.1160.128
QVA1490.1110.1460.1790.2190.2070.1780.1570.1160.1760.1940.1680.1850.2690.1750.1930.2710.1810.1930.2730.1540.1710.2320.2420.2500.2650.2420.1970.1800.1430.1960.216

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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. (NCT01727141)
Timeframe: BL, 12 weeks

Interventionscore on a scale (Least Squares Mean)
QVA1491.94
QAB1491.30
NVA2371.48
Placebo0.71

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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." (NCT01727141)
Timeframe: 12 weeks

InterventionPercentage of participants (Number)
QVA14957.3
QAB14948.0
NVA23746.1
Placebo39.0

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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. (NCT01727141)
Timeframe: baseline (BL), 12 Weeks

InterventionLiter (Least Squares Mean)
QVA1490.211
QAB1490.117
NVA2370.112
Placebo-0.021

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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." (NCT01727141)
Timeframe: BL, 12 Weeks

Interventionscore on a scale (Least Squares Mean)
QVA149-6.4
QAB149-4.6
NVA237-4.8
Placebo-2.7

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Subjective Evaluation of the View on the Operating Field by the Surgeon

"At the end of surgery, the view on the operating field will be graded by the surgeon using a 5-point rating scale:~Extremely poor~Poor~Acceptable~Good~Optimal" (NCT01748643)
Timeframe: Participants will be followed for the duration of the laparoscopic gastric bypass surgery, an expected average of 1.5h

Interventionunits on a scale (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex4.2
Normal Neuromuscular Blockade, Reversal With Neostigmine3.9

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Peak Expiratory Flow

Peak expiratory flow is measured with the Vitalograph® electronic portable peak flow meter. A mean of 3 measurements in the upright posture in bed before and after surgery will be used. (NCT01748643)
Timeframe: Measured the day before surgery and 30min after completion of surgery (when the modified observer's assessment of alertness/sedation scale is 5 (Patient responds readily to name spoken in normal tone))

Interventionpercent change from baseline (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex51.3
Normal Neuromuscular Blockade, Reversal With Neostigmine51.5

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Forced Vital Capacity

Forced vital capacity is measured with the Vitalograph® electronic portable peak flow meter. A mean of 3 measurements in the upright posture in bed before and after surgery will be used. (NCT01748643)
Timeframe: Measured the day before surgery and 30min after completion of surgery (when the modified observer's assessment of alertness/sedation scale is 5 (Patient responds readily to name spoken in normal tone))

Interventionpercent change from baseline (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex51.9
Normal Neuromuscular Blockade, Reversal With Neostigmine49.0

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Number of Intra-abdominal Pressure Rises > 18cmH2O

The number of intra-abdominal pressure rises > 18cmH2O detected by the intra-abdominal CO2 insufflator. (NCT01748643)
Timeframe: Participants will be followed for the duration of the laparoscopic gastric bypass surgery, an expected average of 1.5h

Interventionnumber of intra-abdominal pressure rises (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex0.2
Normal Neuromuscular Blockade, Reversal With Neostigmine0.3

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Forced Expiratory Volume in 1 Second

Forced expiratory volume in 1 second is measured with the Vitalograph® electronic portable peak flow meter. A mean of 3 measurements in the upright posture in bed before and after surgery will be used. (NCT01748643)
Timeframe: Measured the day before surgery and 30min after completion of surgery (when the modified observer's assessment of alertness/sedation scale is 5 (Patient responds readily to name spoken in normal tone))

Interventionpercent change from baseline (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex45.2
Normal Neuromuscular Blockade, Reversal With Neostigmine48.8

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Duration of Surgery

Measured from the time of first skin incision to completion of skin closure. (NCT01748643)
Timeframe: Participants will be followed for the duration of the laparoscopic gastric bypass surgery, an expected average of 1.5h

Interventionminutes (Mean)
Deep Neuromuscular Blockade, Reversal With Sugammadex61.3
Normal Neuromuscular Blockade, Reversal With Neostigmine70.6

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Change From Baseline in Morning Pre-dose Trough FEV1

Change from baseline in morning pre-dose trough forced expiratory volume in 1 second (FEV1) at Week 24. (NCT01854658)
Timeframe: At Week 24

InterventionLiters (Least Squares Mean)
FF MDI (PT005)0.061
GP MDI (PT001)0.063
GFF MDI (PT003)0.116
Placebo MDI0.013

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Rescue Ventolin HFA Use

Change from baseline in average daily rescue Ventolin HFA use over 24 weeks (NCT01854658)
Timeframe: 24 weeks

InterventionPuffs / Day (Least Squares Mean)
FF MDI (PT005)-0.7
GP MDI (PT001)-0.4
GFF MDI (PT003)-1.0
Placebo MDI0.0

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Peak FEV1

Peak change from baseline in FEV1 within 2 hours post-dosing at Week 24 (NCT01854658)
Timeframe: At week 24

InterventionLiters (Least Squares Mean)
FF MDI (PT005)0.268
GP MDI (PT001)0.223
GFF MDI (PT003)0.350
Placebo MDI0.083

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Onset of Action as Assessed by FEV1

Defined as the first time-point using the 5- and 15-minute post dose measurements where the difference in FEV1 from Placebo was statistically significant (NCT01854658)
Timeframe: Day 1

,,,
InterventionLiters (Least Squares Mean)
5 min post dose15 min post dose
FF MDI (PT005)0.1750.212
GFF MDI (PT003)0.1920.237
GP MDI (PT001)0.0520.109
Placebo MDI0.0060.022

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St. George Respiratory Questionnaire (SGRQ) Score

Change from baseline in the SGRQ total score at Week 24. The SGRQ is a disease-specific questionnaire, self-completed by participants, used to evaluate the effect of GFF MDI, FF MDI and GP MDI on health-related quality of life as compared to placebo in subjects with COPD. The scores range from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status). The SGRQ contains 76 items grouped into three domains (symptoms, activity and impacts). Change from Baseline at a particular visit was calculated as the SGRQ total score at that visit minus Baseline. Change from Baseline in total score of -4 units or lower is considered as clinically meaningful improvement in quality of life. (NCT01854658)
Timeframe: 24 weeks

InterventionScores on a scale (Least Squares Mean)
FF MDI (PT005)-2.3
GP MDI (PT001)-2.2
GFF MDI (PT003)-3.0
Placebo MDI-1.2

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Change From Baseline in Morning Pre-dose Trough FEV1 Over 24 Weeks

Change from baseline in morning pre-dose trough forced expiratory volume in 1 second (FEV1) over 24 weeks. FEV1 was assessed at multiple time points post-baseline, and a model-based average of all visits starting from Week 2 through week 24 inclusive was calculated. The change values reported in the table represent the change between the baseline and the average FEV1 post-baseline. (NCT01854658)
Timeframe: Over 24 weeks

InterventionLiters (Least Squares Mean)
FF MDI (PT005)0.080
GP MDI (PT001)0.082
GFF MDI (PT003)0.137
Placebo MDI0.008

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Residual Volume (RV)

Residual Volume (RV) will be measured using whole body plethysmography (Bodybox). (NCT01922271)
Timeframe: Day 1

,
InterventionLiters (Mean)
-45 min (n=152, 150)30 min (n=150, 151)1 hr (n=151, 149)1 hr 30 min (n=151, 149)2 h 30 min (n= 150, 149)3 h 30 min (n= 150, 148)
NVA2374.4333.9963.8913.9103.8933.970
Tiotropium4.3444.0353.9133.9033.8613.895

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Inspiratory Capacity (IC)

Inspiratory Capacity (IC) is the volume of air breathed in by a maximum inspiration at the end of a normal expiration. Whole body plethysmography (Bodybox) will be used to measure IC. (NCT01922271)
Timeframe: Day 1

,
InterventionLiters (Mean)
-45 min (n=152, 150)30 min (n=150, 151)1hr (n=151, 149)1hr 30 min (n=151, 150)2hr 30 min (n=150, 149)3hr 30 min (n=150, 149)
NVA2372.1692.4332.4552.4722.4672.479
Tiotropium2.1932.4222.4352.4572.4742.449

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Functional Resistance Capacity (FRCpleth)

Functional Resistance Capacity (FRCpleth) will be measured using whole body plethysmography (Bodybox). (NCT01922271)
Timeframe: Day 1

,
InterventionLiters (Mean)
-45 min (n=152, 150)30 min (n=150, 151)1 hr (n=151, 149)1 hr 30 min (n=151, 149)2 h 30 min (n= 150, 149)3 h 30 min (n= 150, 148)
NVA2375.2114.8234.7694.7564.7364.761
Tiotropium5.1424.8524.7254.7144.6764.704

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Forced Expiratory Volume in One Second (FEV1) Area Under Curve (AUC) 0-2

Standardized Forced Expiratory Volume in One Second (FEV1) AUC0-2h will be measured via spirometry. The AUC will be calculated from the FEV1 measurements obtained at timepoints between 0 min and 2h using the trapezoidal rule and will be standardized (=divided) by the measurement time (i.e. 2h). (NCT01922271)
Timeframe: Day 1

Interventionliters per hour (Mean)
NVA2371.490
Tiotropium1.453

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Forced Expiratory Volume in One Second (FEV1) 15 Min Post Dose

Forced expiratory volume in 1 second (FEV1) is the amount of air that can be exhaled in one second. FEV1 will be measured by spirometry. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability. (NCT01922271)
Timeframe: Day 1

Interventionliters per hour (Mean)
NVA2371.433
Tiotropium1.398

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Specific Airway Resistance (sRAW)

Specific Airway Resistance (sRAW) indicates volume and resistance-dependent work of breathing needed in order to generate a reference flow rate of 1 L/s, measured by kPa*s. Whole body plethysmography (Bodybox) is used to measure SRaw. (NCT01922271)
Timeframe: Day 1

,
Interventionkilopascal (kPa) (Mean)
-45 min (n=152, 150)30 min (n=150, 151)1 hr (n=151, 149)1 hr 30 min (n=151, 150)2 hr 30 min (n=150, 149)3 hr 30 min (n=150, 149)
NVA2374.2032.9042.6562.6322.6432.779
Tiotropium4.1053.0892.8772.8112.7562.828

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Total Lung Capacity (TLC)

Total Lung Capacity (TLC) is the best vital capacity plus residual volume (RV). Whole body plethysmography (Bodybox) will be used to measure TLC. (NCT01922271)
Timeframe: Day 1

,
InterventionLiters (Mean)
-45 min (n=152, 150)30 min (n=150, 151)1hr (n=151, 149)1hr 30 min (n=151, 149)2hr 30 min (n=150, 149)3hr 30 min (n=150, 148)
NVA2377.3807.2557.2247.2277.2037.240
Tiotropium7.3357.2747.1617.1657.1497.149

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Comparison of Glycopyrronium QD Versus Tiotropium QD on Symptoms Outcome

"Comparison of symptoms outcome between glycopyrronium QD versus tiotropium QD will be conducted via the PROMorning COPD Symptoms questionnaire. This questionnaire will be completed by participants at waking-up, pre-inhalation of study treatment (at home), and they will complete Part 2 of PRO-Morning COPD Symptoms questionnaire at site, 3hours post-inhalation of study treatment. The PRO-Morning COPD Symptoms Questionnaire is a self-administered patient reported outcome (PRO) instrument developed by the sponsor to evaluate patients' experience of early morning symptoms of COPD. The questionnaire consists of two parts : predose and postdose.~Each part has 6 questions and for each question a scale of 0 to 10 can be reached. For the predose and postdose part of the questionnaire you will have then each a total score of 0-60 by adding the sub-scores for each question, higher scores represent worse severity of COPD morning symptoms" (NCT01959516)
Timeframe: day 1 (baseline) and week 4

,
InterventionScores on a scale (Least Squares Mean)
3h post-dose (Day 1)3h post-dose (Week 4)
Glycopyronium From Sequence A to B and Sequence B to A9.706810.4641
Tiotropium From Sequence A to B and Sequence B to A10.397410.3193

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Forced Expiratory Volume in 1 Second (FEV1) AUC0-4h After First Dose of Treatment.

Forced Expiratory Volume in 1 second (FEV1) Area Under the Curve (AUC) will measured via spirometry and calculated from 0 to 4 hours post-dose on day 1 of study treatment. (NCT01959516)
Timeframe: Day 1

InterventionLiters*hours (Least Squares Mean)
Glycopyronium From Sequence A to B and Sequence B to A1.7432
Tiotropium From Sequence A to B and Sequence B to A1.7132

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Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval. (NCT01985334)
Timeframe: Week 12 (Visit 4)

InterventionLiters (Least Squares Mean)
D1 (Any LAMA or LABA and mMRC>1)1.6728
D2 (Indacaterol/Glycopyrronium and mMRC>1)1.7742

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Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA or LAMA Monotherapy or LABA and ICS in Free or FDC on Trough FEV1 at Week 12.

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval. (NCT01985334)
Timeframe: 12 Weeks

InterventionLiters (Least Squares Mean)
C2 +D21.7650
C1 + D11.6789

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Trough FEV1 at Week 12 for Group: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA and ICS in Free or FDC

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval. (NCT01985334)
Timeframe: Week 12 (Visit 4)

InterventionLiters (Least Squares Mean)
C1 (Any LABA and ICS)1.6847
C2 (Indacaterol/Glycopyrronium)1.7558

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Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA or LAMA Monotherapy or LABA and ICS in Free or FDC

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionScore on a scale (Least Squares Mean)
C2 +D22.0354
C1 + D10.8588

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Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC) or vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval (NCT01985334)
Timeframe: 12 Weeks

InterventionLiters (Least Squares Mean)
A2 + B21.8373
A1 + B11.8065

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Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionUnits on a scale (Least Squares Mean)
D1 (Any LAMA or LABA and mMRC>1)0.8632
D2 (Indacaterol/Glycopyrronium and mMRC>1)2.1209

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Mean Change From Baseline Reported Symptoms of COPD for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC

Patient-reported symptoms of COPD combined will be measured using eDiary data reported over the 12 week treatment period. The mean total symptom scores and mean individual symptom scores for the patient were calculated for the whole study period. The mean change from baseline in the total scores and in the individual scores were summarized by treatment and were analyzed for the percentage of nights with no nighttime awakenings and percentage of days with no symptoms. (NCT01985334)
Timeframe: Baseline, 12 weeks

InterventionPercentage of days (Mean)
A1 (Any SABA and/or SAMA)-0.04
A2 (Glycopyrronium)-0.10
B1 (Any LAMA or LABA and mMRC=1)-0.03
B2 (Glycopyrronium and mMRC=1)-0.05
C1 (Any LABA and ICS)-0.05
C2 (Indacaterol/Glycopyrronium)-0.07
D1 (Any LAMA or LABA and mMRC>1)-0.04
D2 (Indacaterol/Glycopyrronium and mMRC>1)-0.09

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Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Indacaterol Maleate and Glycopyrronium Bromide FDC vs. LABA and ICS in Free or FDC

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionUnits on a scale (Least Squares Mean)
C1 (Any LABA and ICS)0.8508
C2 (Indacaterol/Glycopyrronium)1.9491

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Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC)

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionUnits on a scale (Least Squares Mean)
A1 (Any SABA and/or SAMA)0.5117
A2 (Glycopyrronium)2.3005

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Change From Baseline on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionUnits on a scale (Least Squares Mean)
B1 (Any LAMA or LABA and mMRC=1)0.6969
B2 (Glycopyrronium and mMRC=1)1.4351

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Change From Baseline on Total Score of COPD Assessment Test (CAT) for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC

Total score of COPD Assessment Test (CAT) will be measured at baseline and at week 12. This questionnaire is completed by the patient. The score ranges from 0-40 where higher scores represent worse health status. CAT scores ≥ 10 are associated with significantly impaired health status. (NCT01985334)
Timeframe: Day 1 (baseline) and Week 12

InterventionScore (Mean)
A1 (Any SABA and/or SAMA)0.1
A2 (Glycopyrronium)-1.8
B1 (Any LAMA or LABA and mMRC=1)0.1
B2 (Glycopyrronium and mMRC=1)-0.5
C1 (Any LABA and ICS)-0.4
C2 (Indacaterol/Glycopyrronium)-1.4
D1 (Any LAMA or LABA and mMRC>1)-0.9
D2 (Indacaterol/Glycopyrronium and mMRC>1)-1.9

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Change From Baseline on Total Score of Clinical COPD Questionnaire (CCQ) for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC

"The Clinical COPD Questionnaire (CCQ) is a self-administered 10-item questionnaire developed to measure clinical control in patients with COPD. Patients will be instructed to recall their experiences during the previous week. They respond to each question using a 7-point scale from 0 = asymptomatic/no imitation to 6 = extremely symptomatic/totally limited. The questionnaire is divided into 3 domains (symptoms [items 1, 2, 5, and 6] functional [items 7, 8, 9, and 10] and mental state [items 3 and 4]). The overall clinical COPD control score and the scores of the domains are calculated by adding all the scores together and dividing this sum by the number of questions.~Thus, the overall clinical COPD control score as well as the score on each of the three domains varies between 0 (very good control) to 6 (extremely poor control)." (NCT01985334)
Timeframe: Day 1 (baseline) and Week 12

InterventionScore (Mean)
A1 (Any SABA and/or SAMA)-0.0
A2 (Glycopyrronium)-0.3
B1 (Any LAMA or LABA and mMRC=1)0.0
B2 (Glycopyrronium and mMRC=1)-0.1
C1 (Any LABA and ICS)-0.1
C2 (Indacaterol/Glycopyrronium)-0.2
D1 (Any LAMA or LABA and mMRC>1)-0.1
D2 (Indacaterol/Glycopyrronium and mMRC>1)-0.3

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Change From Baseline on on Transition Dyspnea Index (TDI) for Groups: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC) or Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. (NCT01985334)
Timeframe: Day 1 (baseline) and week 12

InterventionScore on a scale (Least Squares Mean)
A2 +B21.6315
A1 +B10.6562

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Mean Number of Puffs of Rescue Medication Use for Groups: Glycopyrronium and Indacaterol Maleate and Glycopyrronium Bromide FDC

Mean number of puffs of rescue medication use will be measured using eDiary data over 12 weeks of treatment. (NCT01985334)
Timeframe: 12 weeks

InterventionNumber of puffs (Mean)
A1 (Any SABA and/or SAMA)1.8
A2 (Glycopyrronium)1.0
B1 (Any LAMA or LABA and mMRC=1)0.8
B2 (Glycopyrronium and mMRC=1)0.7
C1 (Any LABA and ICS)1.6
C2 (Indacaterol/Glycopyrronium)1.1
D1 (Any LAMA or LABA and mMRC>1)1.4
D2 (Indacaterol/Glycopyrronium and mMRC>1)1.1

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Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Long-acting Bronchodilators (LABA or LAMA Monotherapy)

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval (NCT01985334)
Timeframe: Week 12 (Visit 4)

InterventionLiters (Least Squares Mean)
B1 (Any LAMA or LABA and mMRC=1)1.8004
B2 (Glycopyrronium and mMRC=1)1.8215

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Trough FEV1 at Week 12 for Group: Glycopyrronium vs. Short-acting Bronchodilators (SABA and/or SAMA as Monotherapy or in Free or FDC)

Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval (NCT01985334)
Timeframe: Week 12 (Visit 4)

InterventionLiters (Least Squares Mean)
A1 (Any SABA and/or SAMA)1.8264
A2 (Glycopyrronium)1.8916

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Percentage of Subjects Who Have a Minimum 2-grade Improvement in HDSS From Baseline at Week 4

"HDSS is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities.~1 (Best), 2, 3, 4 (Worst)" (NCT02016885)
Timeframe: Baseline - Week 4

InterventionParticipants (Count of Participants)
Glycopyrrolate, 1.0%14
Glycopyrrolate, 2.0%20
Glycopyrrolate, 3.0%21
Glycopyrrolate, 4.0%18
Vehicle9

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Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 6

(NCT02016885)
Timeframe: Baseline - Week 6

InterventionParticipants (Count of Participants)
Glycopyrrolate, 1.0%24
Glycopyrrolate, 2.0%27
Glycopyrrolate, 3.0%29
Glycopyrrolate, 4.0%23
Vehicle25

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Change in Dermatology Life Quality Index (DLQI) From Baseline at Week 4

The DLQI is a ten question questionnaire, used to measure the impact of skin disease on the quality of life of an affected person. The scoring of each question is as follows: Very much (3), A lot (2), A little (1), Not at all (0), Not relevant (0). Is calculated by summing the score of each question resulting in a max of 30 and a min of 0. Higher the score the more Quality of life is impaired. (NCT02016885)
Timeframe: Baseline - Week 4

Interventionscores on a scale (Mean)
Glycopyrrolate, 1.0%-6.2
Glycopyrrolate, 2.0%-6.6
Glycopyrrolate, 3.0%-7.0
Glycopyrrolate, 4.0%-5.9
Vehicle-3.8

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Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 6

(NCT02016885)
Timeframe: Baseline - Week 6

Interventionmg/5 min (Mean)
Glycopyrrolate, 1.0%-32.08
Glycopyrrolate, 2.0%-51.36
Glycopyrrolate, 3.0%-72.23
Glycopyrrolate, 4.0%-57.15
Vehicle-55.14

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Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 4

Subjects are acclimated to the environment for 30 minutes. Dry gauze is weighed. The dry gauze is then applied to the subject's axilla with the arm down by the subject's side or on their lap during the 5-minute period of sweat production. The gauze with the sweat is then weighed. The difference between the Weight of the gauze with sweat and the dry gauze is the gravimetric sweat measurement in mg/5min. (NCT02016885)
Timeframe: Baseline - Week 4

Interventionmg/5 min (Mean)
Glycopyrrolate, 1.0%-56.63
Glycopyrrolate, 2.0%-67.17
Glycopyrrolate, 3.0%-91.39
Glycopyrrolate, 4.0%-88.40
Vehicle-55.80

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Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 4

(NCT02016885)
Timeframe: Baseline - Week 4

InterventionParticipants (Count of Participants)
Glycopyrrolate, 1.0%27
Glycopyrrolate, 2.0%30
Glycopyrrolate, 3.0%35
Glycopyrrolate, 4.0%25
Vehicle28

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Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 4

(NCT02129660)
Timeframe: Baseline - Week 4

InterventionParticipants (Count of Participants)
Dose 1 of Glycopyrrolate16
Dose 2 of Glycopyrrolate17
Dose 1 of Glycopyrronium15
Dose 2 of Glycopyrronium14
Vehicle12

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Percentage of Subjects Who Have a Minimum 1-grade Improvement in HDSS From Baseline at Week 6

(NCT02129660)
Timeframe: Baseline - Week 6

InterventionParticipants (Count of Participants)
Dose 1 of Glycopyrrolate19
Dose 2 of Glycopyrrolate16
Dose 1 of Glycopyrronium17
Dose 2 of Glycopyrronium13
Vehicle13

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Percentage of Subjects Who Have a Minimum 2-grade Improvement in HDSS From Baseline at Week 4

"HDSS is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities.~1 (Best), 2, 3, 4 (Worst)" (NCT02129660)
Timeframe: Baseline - Week 4/ET

InterventionParticipants (Count of Participants)
Dose 1 of Glycopyrrolate10
Dose 2 of Glycopyrrolate10
Dose 1 of Glycopyrronium9
Dose 2 of Glycopyrronium10
Vehicle6

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Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 4

Subjects are acclimated to the environment for 30 minutes. Dry gauze is weighed. The dry gauze is then applied to the subject's axilla with the arm down by the subject's side or on their lap during the 5-minute period of sweat production. The gauze with the sweat is then weighed. The difference between the Weight of the gauze with sweat and the dry gauze is the gravimetric sweat measurement in mg/5min. (NCT02129660)
Timeframe: Baseline - Week 4

Interventionmg/5 min (Mean)
Dose 1 of Glycopyrrolate-104.20
Dose 2 of Glycopyrrolate-58.27
Dose 1 of Glycopyrronium-105.28
Dose 2 of Glycopyrronium-72.69
Vehicle-53.85

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Absolute Change in the Gravimetrically Measured Sweat Production From Baseline to Week 6

(NCT02129660)
Timeframe: Baseline - Week 6

Interventionmg/5 min (Mean)
Dose 1 of Glycopyrrolate-92.20
Dose 2 of Glycopyrrolate-44.37
Dose 1 of Glycopyrronium-96.98
Dose 2 of Glycopyrronium-66.17
Vehicle-71.06

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Percentage of Subjects Who Had at Least 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4

(NCT02129660)
Timeframe: Baseline - Week 4

InterventionParticipants (Count of Participants)
Dose 1 of Glycopyrrolate19
Dose 2 of Glycopyrrolate16
Dose 1 of Glycopyrronium20
Dose 2 of Glycopyrronium16
Vehicle15

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Percentage of Subjects Who Had at Least 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 6

(NCT02129660)
Timeframe: Baseline - Week 6

InterventionParticipants (Count of Participants)
Dose 1 of Glycopyrrolate15
Dose 2 of Glycopyrrolate15
Dose 1 of Glycopyrronium17
Dose 2 of Glycopyrronium16
Vehicle14

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T 1/2

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (T 1/2) (NCT02196714)
Timeframe: Day 1

Interventionh (Mean)
GFF MDI 28.8/9.6 ug9.49
GFF MDI 14.4/9.6 ug4.14
GP MDI 28.8 ug24.87
GP MDI 14.4 ug19.13

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 hours

,,
Interventionμmol/L (Mean)
Creatinine (μmol/L)Direct bilirubin (μmol/L)Iron (μmol/L)Total bilirubin (μmol/L)
GFF MDI 14.4/9.6 ug4.92-2.53-2.81888-7.14
GFF MDI 28.8/9.6 ug1.88-3.06-5.42524-8.19
GP MDI 28.8 ug3.61-2.64-2.58949-7.20

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 hours

,,
InterventionIU/L (Mean)
ALT (IU/L)Alkaline phosphatase (IU/L)AST (IU/L)Gamma glutamyl transferase (IU/L)
GFF MDI 14.4/9.6 ug-1.7-5.0-3.3-1.6
GFF MDI 28.8/9.6 ug-3.1-5.2-4.2-2.5
GP MDI 28.8 ug-2.4-6.0-3.7-2.2

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 hours

,,
Interventiong/L (Mean)
Albumin (g/L)Protein (g/L)
GFF MDI 14.4/9.6 ug-6.9-10.8
GFF MDI 28.8/9.6 ug-7.1-10.9
GP MDI 28.8 ug-6.7-10.3

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Vd/F

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrroniuml by Treatment (NCT02196714)
Timeframe: Day 1

InterventionL (Mean)
GFF MDI 28.8/9.6 ug3508.00
GFF MDI 14.4/9.6 ug2577.78
GP MDI 28.8 µg3555.88
GP MDI 14.4 µg2101.03

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Vd/F

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (NCT02196714)
Timeframe: Day 1

InterventionL (Mean)
GFF MDI 28.8/9.6 ug1187.75
GFF MDI 14.4/9.6 ug1054.16

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Tmax

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (tmax) (NCT02196714)
Timeframe: Day 1

Interventionh (Mean)
GFF MDI 28.8/9.6 ug0.10
GFF MDI 14.4/9.6 ug0.10
GP MDI 28.8 ug0.10
GP MDI 14.4 ug0.10

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Tmax

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (tmax) (NCT02196714)
Timeframe: Day 1

Interventionh (Mean)
GFF MDI 28.8/9.6 ug0.10
GFF MDI 14.4/9.6 ug0.10

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T 1/2

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (T 1/2) (NCT02196714)
Timeframe: Day 1

Interventionh (Mean)
GFF MDI 28.8/9.6 ug5.45
GFF MDI 14.4/9.6 ug5.25

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Lambda z

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (NCT02196714)
Timeframe: Day 1

Intervention1/h (Mean)
GFF MDI 28.8/9.6 ug0.1506
GFF MDI 14.4/9.6 ug0.1983
GP MDI 28.8 ug0.1100
GP MDI 14.4 ug0.1614

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Lambda z

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (NCT02196714)
Timeframe: Day 1

Intervention1/h (Mean)
GFF MDI 28.8/9.6 ug0.1412
GFF MDI 14.4/9.6 ug0.1470

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Cmax

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (Cmax) (NCT02196714)
Timeframe: Day 1

Interventionpg/mL (Mean)
GFF MDI 28.8/9.6 ug15.23
GFF MDI 14.4/9.6 ug9.09
GP MDI 28.8 ug16.85
GP MDI 14.4 µg7.26

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Cmax

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (Cmax) (NCT02196714)
Timeframe: Day 1

Interventionpg/mL (Mean)
GFF MDI 28.8/9.6 ug10.74
GFF MDI 14.4/9.6 ug11.99

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CL/F

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (NCT02196714)
Timeframe: Day 1

InterventionL/h (Mean)
GFF MDI 28.8/9.6 ug657.91
GFF MDI 14.4/9.6 ug449.10
GP MDI 28.8 µg785.60
GP MDI 14.4 µg423.12

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CL/F

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (NCT02196714)
Timeframe: Day 1

InterventionL/h (Mean)
GFF MDI 28.8/9.6 ug168.95
GFF MDI 14.4/9.6 ug161.55

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Change in QTc Fridericia's Interval From Pre-dose to 12 Hours Post Dose

Change in QTc Fridericia's Interval from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

Interventionmsec (Mean)
GFF MDI 28.8/9.6 ug-4.8
GFF MDI 14.4/9.6 ug-5.4
GP MDI 28.8 ug-10.8

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Change in QTc Bazett Interval From Pre-dose to 12 Hours Post Dose

Change in QTc Bazett Interval from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

Interventionmsec (Mean)
GFF MDI 28.8/9.6 ug7.2
GFF MDI 14.4/9.6 ug4.4
GP MDI 28.8 ug-5.8

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AUC 0-∞

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (AUC 0-∞) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug61.88
GFF MDI 14.4/9.6 ug61.43

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 Hours

,,
Intervention10^9cells/L (Mean)
Basophils (10^9cells/L)Eosinophils (10^9cells/L)Granulocytes (10^9cells/L)Leukocytes (10^9cells/L)Lymphocytes (10^9cells/L)Monocytes (10^9cells/L)Platelets (10^9cells/L)
GFF MDI 14.4/9.6 ug0.0000.0330.4830.7800.2060.056-14.4
GFF MDI 28.8/9.6 ug0.0070.0440.2220.4840.1470.065-22.4
GP MDI 28.8 ug0.0010.0650.4430.8000.2350.055-23.1

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 Hours

,,
InterventionRatio (Mean)
Basophils/leukocytes (ratio)Eosinophils/leukocytes (ratio)Granulocytes/leukocytes (ratio)Hematocrit (ratio)Lymphocytes/leukocytes (ratio)Monocytes/leukocytes (ratio)
GFF MDI 14.4/9.6 ug-0.00130.00260.0003-0.041-0.00190.0004
GFF MDI 28.8/9.6 ug-0.00010.00340.0043-0.040-0.01100.0034
GP MDI 28.8 ug-0.00130.0046-0.0010-0.043-0.0018-0.0006

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 Hours

,,
Interventiong/L (Mean)
Ery. mean corpuscuar HGB (g/L)Hemoglobin (g/L)
GFF MDI 14.4/9.6 ug8.5-10.61
GFF MDI 28.8/9.6 ug12.0-8.81
GP MDI 28.8 ug11.4-10.38

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Change in Mean Glucose and Potassium Results (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Glucose and Potassium Results (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 hours

,,
Interventionmmol/L (Mean)
Glucose (mmol/L) 30 minutes post-doseGlucose (mmol/L) 2 hours post-doseGlucose (mmol/L) 4 hours post-doseGlucose (mmol/L) 12 hours post-dosePotassium (mmol/L) 30 minutes post-dosePotassium (mmol/L) 2 hours post-dosePotassium (mmol/L) 4 hours post-dosePotassium (mmol/L) 12 hours post-dose
GFF MDI 14.4/9.6 ug-0.08-0.01-0.240.180.00-0.07-0.12-0.06
GFF MDI 28.8/9.6 ug-0.030.05-0.080.100.01-0.02-0.010.05
GP MDI 28.8 ug-0.01-0.06-0.160.230.060.10-0.070.07

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Change in QT Interval From Pre-dose to 12 Hours Post Dose

Change in QT Interval from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

Interventionmsec (Mean)
GFF MDI 28.8/9.6 ug-28.5
GFF MDI 14.4/9.6 ug-24.8
GP MDI 28.8 ug-20.5

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AUC 0-∞

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (AUC 0-∞) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug46.26
GFF MDI 14.4/9.6 ug32.18
GP MDI 28.8 µg37.32
GP MDI 14.4 µg34.04

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AUC 0-12

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (AUC 0-12) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug44.15
GFF MDI 14.4/9.6 ug42.54

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AUC 0-12

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (AUC 0-12) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug45.43
GFF MDI 14.4/9.6 ug21.75
GP MDI 28.8 ug50.59
GP MDI 14.4 ug24.72

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AUC 0-t

Descriptive Statistics for Pharmacokinetic Parameters of Formoterol by Treatment (AUC 0-t) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug45.96
GFF MDI 14.4/9.6 ug42.39

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Change in QRS Duration From Pre-dose to 12 Hours Post Dose

Change in QRS duration from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

Interventionmsec (Mean)
GFF MDI 28.8/9.6 ug-3.9
GFF MDI 14.4/9.6 ug-1.1
GP MDI 28.8 ug-4.0

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AUC 0-t

Descriptive Statistics for Pharmacokinetic Parameters of Glycopyrronium by Treatment (AUC 0-t) (NCT02196714)
Timeframe: Day 1

Interventionh*pg/mL (Mean)
GFF MDI 28.8/9.6 ug53.52
GFF MDI 14.4/9.6 ug21.37
GP MDI 28.8 ug64.05
GP MDI 14.4 µg23.72

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Change in Heart Rate From Pre-dose to 12 Hours Post Dose

Change in Heart Rate from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

InterventionBeats/Min (Mean)
GFF MDI 28.8/9.6 ug11.3
GFF MDI 14.4/9.6 ug9.3
GP MDI 28.8 ug4.5

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (eGFR) (NCT02196714)
Timeframe: 12 hours

InterventionmL/min/1.73m2 (Mean)
GFF MDI 28.8/9.6 ug-4.2
GFF MDI 14.4/9.6 ug-7.2
GP MDI 28.8 ug-3.5

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (Ferritin) (NCT02196714)
Timeframe: 12 hours

Interventionμg/L (Mean)
GFF MDI 28.8/9.6 ug-14.169
GFF MDI 14.4/9.6 ug-11.949
GP MDI 28.8 ug-11.669

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (Ery. mean corpuscuar hemoglobin) (NCT02196714)
Timeframe: 12 Hours

Interventionpg/cell (Mean)
GFF MDI 28.8/9.6 ug0.78
GFF MDI 14.4/9.6 ug0.49
GP MDI 28.8 ug0.75

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (Ery. mean corpuscuar volume) (NCT02196714)
Timeframe: 12 Hours

InterventionfL (Mean)
GFF MDI 28.8/9.6 ug-0.9
GFF MDI 14.4/9.6 ug-0.8
GP MDI 28.8 ug-0.9

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Change in Mean Hematology Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Hematology Parameters (±SD) from Pre-dose to 12 Hours Post-dose (Erythrocytes) (NCT02196714)
Timeframe: 12 Hours

Intervention10^12cells/L (Mean)
GFF MDI 28.8/9.6 ug-0.391
GFF MDI 14.4/9.6 ug-0.419
GP MDI 28.8 ug-0.433

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Change in PR Interval From Pre-dose to 12 Hours Post Dose

Change in PR Interval from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

Interventionmsec (Mean)
GFF MDI 28.8/9.6 ug-10.7
GFF MDI 14.4/9.6 ug-8.5
GP MDI 28.8 ug-7.4

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Change in QRS Axis From Pre-dose to 12 Hours Post Dose

Change in QRS axis from Pre-dose to 12 hours Post dose (NCT02196714)
Timeframe: 12 hours

InterventionQRS axis (Mean)
GFF MDI 28.8/9.6 ug-0.5
GFF MDI 14.4/9.6 ug4.1
GP MDI 28.8 ug0.0

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Change in Mean Chemistry Parameters (±SD) From Pre-dose to 12 Hours Post-dose

Change in Mean Chemistry Parameters (±SD) from Pre-dose to 12 Hours Post-dose (NCT02196714)
Timeframe: 12 hours

,,
Interventionmmol/L (Mean)
Blood urea nitrogen (mmol/L)Calcium (mmol/L)Chloride (mmol/L)Magnesium (mmol/L)Phosphorus (mmol/L)Sodium (mmol/L)
GFF MDI 14.4/9.6 ug0.34-0.142.5-0.070.1630.5
GFF MDI 28.8/9.6 ug0.01-0.153.0-0.050.1350.9
GP MDI 28.8 ug0.74-0.132.3-0.040.1330.1

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Change From Baseline in Trough FEV1 (Forced Expiratory Volume) to Week 4

Portable spirometers will be provided to investigators and they will use this device for all of their patient measurements of FEV1 during the trial (NCT02202616)
Timeframe: Baseline, week 4

InterventionLiter (Mean)
QVA149 110/50 After Flu/Sal0.12
QVA149 110/50 After Tio0.14

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Single Point and Change in Baseline Dyspnea Index and Transitional Dyspnea Index (BDI/TDI)

A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing). BDI/TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. BDI was measured at day 1 prior to the first dose with domain scores ranging from 0=very severe to 4=no impairment and a total score ranging from 0 to 12(best). TDI captures changes from baseline. Each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. The BDI was assessed at Baseline, whereas the TDI was assessed at Week 4 and Week 16. (NCT02202616)
Timeframe: Baseline, Week 4, week 16

,
InterventionScore (Mean)
BDI week 0TDI week 4TDI week 16
QVA149 110/50 After Flu/Sal6.52.22.9
QVA149 110/50 After Tio6.82.02.4

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Change From Baseline in Trough (Forced Expiratory Volume (FEV1) (Pre-dose FEV1)

Primary end points: To evaluate the real-life effectiveness of QVA149 (indacaterol 110 mcg/glycopyrronium 50 mcg) in the management of patients with COPD who have symptoms defined as CAT score >10 with tiotropium monotherapy; effectiveness will be assessed as the mean change in trough FEV1 from baseline to 16 weeks. and to evaluate the real-life effectiveness of QVA149 (indacaterol 110 mcg/glycopyrronium 50 mcg) in the management of patients with COPD who have symptoms defined as CAT score >10 while on treatment with FDC of fluticasone propionate/salmeterol; effectiveness will be assessed as the mean change in trough FEV1 from baseline to 16 weeks. (NCT02202616)
Timeframe: 16 weeks study

InterventionLiter (Mean)
QVA149 110/50 After Flu/Sal0.17
QVA149 110/50 After Tio0.18

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Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Assessment Questionnaire (CAT)

The CAT is an 8 item questionnaire that assesses the impact of COPD on the patient's functional status. Scores for each of the 8 items are summed to give an overall score (out of 40). The score ranges from 0-40 where higher scores represent worse health status. CAT scores ≥ 10 are associated with significantly impaired health status. (NCT02202616)
Timeframe: Baseline, week 4, week 16

,
InterventionScore (Mean)
Week 4Week 16
QVA149 110/50 After Flu/Sal-5.9-8.2
QVA149 110/50 After Tio-4.7-5.9

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Percent of Time Spent During the Night Below 90 % in Blood Oxygen Saturation

The time during the night spent below 90 % in blood oxygen saturation following 4 weeks administration of QVA149 compared to placebo was assessed. Night time oxygenation (SpO2) was measured using polygraphy. (NCT02233543)
Timeframe: Post 4 weeks administration of QVA149, post 4 weeks administration of placebo

InterventionPercent (Least Squares Mean)
QVA149 (Indacaterol/Glycopyrronium)44.37
Placebo36.58

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Mean Night-time Blood Oxygenation

The mean night-time blood oxygenation following 4 weeks administration of QVA149 compared to placebo was assessed. Night time oxygenation (SpO2) was measured using polygraphy. (NCT02233543)
Timeframe: Post 4 weeks administration of QVA149, post 4 weeks administration of placebo

InterventionPercent Oxygenation (Least Squares Mean)
QVA149 (Indacaterol/Glycopyrronium)89.59
Placebo90.04

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Change From Baseline in Trough FEV1 on Day 85

FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. Trough FEV1 on Day 85 is defined as the mean of the FEV1 values obtained 23 and 24 hours after dosing on Day 84 (Week 12). Trough FEV1 measurements were taken electronically by spirometry on Days 2, 28, 56, 84 and 85. Baseline trough FEV1 is the mean of the two assessments made -30 and -5 minutes (min) pre-dose on Day 1. Change from baseline was calculated as the trough FEV1 value on Day 85 minus the BL value. Analysis performed using a repeated measures model with covariates of treatment, baseline FEV1, centre group, 24 hour subset flag, Day, Day by baseline and Day by treatment interactions. The least squares mean changes are presented here. (NCT02236611)
Timeframe: Baseline (BL) and Day 85

InterventionLiter (Least Squares Mean)
UMEC 62.5 mcg QD0.123
GLYCO 44 mcg QD0.099

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Percentage of Devices in Agreement Between Laboratory-advanced Does Indicator Actuation and Weight-based Actuation Count at Last Available Visit.

Percentage of devices whose number of actuations counted at the end of the study, using the dose indicator reading, was consistent (±20 actuations) with the number of actuations used as estimated by the change in MDI weight (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage (Number)
GFF MDI (PT003)75.0

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Percentage of Devices in Agreement Between Laboratory-Advanced Dose Indicator Actuation Count and Subject-Reported Actuation Count at the Last Available Visit

Percentage of devices whose number of actuations counted at the end of the study, using the lab-advanced dose indicator reading, was consistent (±20 actuations) with the number of actuations used as reported by the subject (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage of devices (Number)
GFF MDI (PT003)96.2

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Percentage of Devices Where the Dose Indicator Actuation Count is >20 Less Than the Subject-reported Actuation Count (Undercount)

Percentage of devices where the dose indicator actuation count is >20 less than the subject-reported actuation count (undercount) (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage (Number)
GFF MDI (PT003)2.9

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Percentage of Correct Advances (±2 or ±4 Actuations) of the Dose Indicator Based on Subject-reported Actuation Count

Percentage of Correct Advances (±2 or ±4 Actuations) of the Dose Indicator Based on Subject-reported Actuation Count (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage of correct advances (Number)
Correct within ±2 actuationsCorrect within ±4 actuations
GFF MDI (PT003)87.393.2

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Percentage of Devices in Agreement Between eCRF-Based Dose Indicator Actuation Count and Weight-Based Actuation Count at the Last Available Visit

Percentage of devices whose number of actuations counted at the end of the study, using the dose indicator reading, was consistent (±20 actuations) with the number of actuations used as estimated by the change in MDI weight (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage of Devices (Number)
GFF MDI (PT003)86.9

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Dose Indicator Actuation Consistency: Percentage of Devices in Agreement Between CRF-Based Dose Indicator Actuation Count

Dose Indicator Actuation Consistency: Percentage of Devices in Agreement Between CRF-Based Dose Indicator Actuation Count and Subject-Reported Actuation Count at the Last Available Visit: ITT Population (NCT02268396)
Timeframe: Over the life of the canister/120 puffs - up to 4 weeks

InterventionPercentage (Number)
GFF MDI (PT003)96.4

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Percentage of Subjects With Treatment-emergent Serious Adverse

A treatment emergent serious adverse event (SAE) is any SAE that occurred on or after the first dose of study medication, any SAE with a missing start date and a stop date on or after the first dose of study medication, or any SAE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to Week 48

Interventionpercentage of participants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer12.3
Spiriva 18 mcg QD Handihaler10.5

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Percentage of Subjects Who Discontinue the Study Due to TEAE

A TEAE is any adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to 48 Weeks

Interventionpercentage of participants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer10.0
Spiriva 18 mcg QD Handihaler2.8

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Number of Subjects With Treatment-emergent Serious Adverse Events (SAE)

A treatment emergent serious adverse event (SAE) is any SAE that occurred on or after the first dose of study medication, any SAE with a missing start date and a stop date on or after the first dose of study medication, or any SAE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to Week 48

Interventionparticipants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer76
Spiriva 18 mcg QD Handihaler49

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Number of Subjects With Treatment-emergent Adverse Events (TEAE)

A TEAE is any adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to Week 48

Interventionparticipants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer430
Spiriva 18 mcg QD Handihaler312

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Percentage of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke

"All deaths and any other findings suggestive of a potential MACE (including clinically relevant information and SAEs, and all PTs form the SMQs myocardial infarction, other ischemic heart disease, central nervous system hemorrhages and cerebrovascular conditions) were sent to an adjudication committee for review and categorized as CV death, nonfatal MI, and nonfatal stroke. The MACE score was defined as the total number of subjects with CV deaths, nonfatal MIs, and nonfatal strokes. These events were collected from the first date of study medication until the date of last contact." (NCT02276222)
Timeframe: Up to 48 Weeks

,
Interventionpercentage of participants (Number)
MACE scorecardiovascular deathnon-fatal myocardial infarctionnon-fatal stroke
Spiriva 18 mcg QD Handihaler1.70.41.10.2
SUN-101 50 mcg BID eFlow (CS) Nebulizer0.50.20.30

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Number of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke

"All deaths and any other findings suggestive of a potential MACE (including clinically relevant information and SAEs, and all PTs form the SMQs myocardial infarction, other ischemic heart disease, central nervous system hemorrhages and cerebrovascular conditions) were sent to an adjudication committee for review and categorized as CV death, nonfatal MI, and nonfatal stroke. The MACE score was defined as the total number of subjects with CV deaths, nonfatal MIs, and nonfatal strokes. These events were collected from the first date of study medication until the date of last contact." (NCT02276222)
Timeframe: Up to Week 48

,
Interventionparticipants (Number)
MACE scorecardiovascular deathnon-fatal myocardial infarctionnon-fatal stroke
Spiriva 18 mcg QD Handihaler8251
SUN-101 50 mcg BID eFlow (CS) Nebulizer3120

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Incidence Rate Per 1000 Person Years of Subjects With Major Adverse Cardiac Events (MACE), Including Cardiovascular Death, Ischemia/Infarction, and Stroke

"All deaths and any other findings suggestive of a potential MACE (including clinically relevant information and SAEs, and all PTs form the SMQs myocardial infarction, other ischemic heart disease, central nervous system hemorrhages and cerebrovascular conditions) were sent to an adjudication committee for review and categorized as CV death, nonfatal MI, and nonfatal stroke. The MACE score was defined as the total number of subjects with CV deaths, nonfatal MIs, and nonfatal strokes. These events were collected from the first date of study medication until the date of last contact." (NCT02276222)
Timeframe: up to week 48

,
Interventionevent per 1000 person years (Number)
MACE scorecardiovascular deathnon-fatal myocardial infarctionnon-fatal stroke
Spiriva 18 mcg QD Handihaler20.35.112.72.5
SUN-101 50 mcg BID eFlow (CS) Nebulizer6.42.14.30

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Number of Subjects Who Discontinue the Study Due to TEAE

A TEAE is any adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to Week 48

Interventionparticipants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer62
Spiriva 18 mcg QD Handihaler13

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Mean Change From Baseline Over 48 Weeks in Trough FEV1 for All Subjects

"Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the average of the FEV1 values collected at the end of the dosing interval at each clinic visit. The mean change from baseline in trough FEV1 over the 48 week treatment period is calculated by averaging the trough FEV1 changes from baseline across all study visits while subjects are taking randomized treatment.~Values affected by other medication use were to be set to missing." (NCT02276222)
Timeframe: Up to Week 48

Interventionliters (Least Squares Mean)
SUN-101 50 mcg BID eFlow (CS) Nebulizer0.1016
Spiriva 18 mcg QD Handihaler0.0931

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Percentage of Subjects With Treatment-emergent Adverse Events

A TEAE is any adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02276222)
Timeframe: Up to Week 48

Interventionpercentage of participants (Number)
SUN-101 50 mcg BID eFlow (CS) Nebulizer69.4
Spiriva 18 mcg QD Handihaler67.0

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Change From Baseline in SGRQ Total Score Over Weeks 12-24 , Japan & EU/SK/TW Approach

Change from baseline in the SGRQ total score. The SGRQ is a disease-specific questionnaire, self-completed by participants, used to evaluate the effect of GFF MDI, FF MDI and GP MDI on health-related quality of life as compared to placebo in subjects with COPD. The scores range from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status). The SGRQ contains 76 items grouped into three domains (symptoms, activity and impacts). Change from Baseline at a particular visit was calculated as the SGRQ total score at that visit minus Baseline. Change from Baseline in total score of -4 units or lower is considered as clinically meaningful improvement in quality of life (NCT02343458)
Timeframe: over weeks 12-24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug-5.2
FF MDI 9.6 ug-5.0
GP MDI 14.4 ug-3.6
Placebo MDI-1.7

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Change From Baseline in Morning Pre-dose Trough FEV1 Over Weeks 12-24, Japan Approach

Change from baseline in morning pre-dose trough FEV1 over weeks 12-24, Japan approach (NCT02343458)
Timeframe: over weeks 12-24

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug128
FF MDI 9.6 ug54
GP MDI 14.4 ug74
Placebo MDI-25

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Change From Baseline in SGRQ Total Score at Week 24, US/China Approach

Change from baseline in the SGRQ total score. The SGRQ is a disease-specific questionnaire, self-completed by participants, used to evaluate the effect of GFF MDI, FF MDI and GP MDI on health-related quality of life as compared to placebo in subjects with COPD. The scores range from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status). The SGRQ contains 76 items grouped into three domains (symptoms, activity and impacts). Change from Baseline at a particular visit was calculated as the SGRQ total score at that visit minus Baseline. Change from Baseline in total score of -4 units or lower is considered as clinically meaningful improvement in quality of life (NCT02343458)
Timeframe: at week 24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug-5.3
FF MDI 9.6 ug-5.6
GP MDI 14.4 ug-3.7
Placebo MDI-0.9

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Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks EU/SK/TW Approach

Peak change from baseline in FEV1 within 2 hours post-dosing over 24 weeks EU/SK/TW approach (NCT02343458)
Timeframe: over 24 weeks

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug375
FF MDI 9.6 ug277
GP MDI 14.4 ug234
Placebo MDI82

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Change From Baseline in SGRQ Total Score at Week 24 in Symptomatic Population, US/China Approach

Change from baseline in the SGRQ total score. The SGRQ is a disease-specific questionnaire, self-completed by participants, used to evaluate the effect of GFF MDI, FF MDI and GP MDI on health-related quality of life as compared to placebo in subjects with COPD. The scores range from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status). The SGRQ contains 76 items grouped into three domains (symptoms, activity and impacts). Change from Baseline at a particular visit was calculated as the SGRQ total score at that visit minus Baseline. Change from Baseline in total score of -4 units or lower is considered as clinically meaningful improvement in quality of life (NCT02343458)
Timeframe: at week 24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug-6.9
FF MDI 9.6 ug-7.8
GP MDI 14.4 ug-3.8
Placebo MDI-1.6

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Change From Baseline in Morning Pre-dose Trough FEV1 Over 24 Weeks. Primary Endpoint, EU/SK/TW Approach, Secondary Endpoint US/China Approach.

Change from baseline in morning pre-dose trough FEV1 over 24 weeks. Primary endpoint, EU/SK/TW approach, Secondary endpoint US/China approach. (NCT02343458)
Timeframe: over 24 weeks

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug135
FF MDI 9.6 ug63
GP MDI 14.4 ug80
Placebo MDI-20

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Change From Baseline in Morning Pre-dose Trough FEV1 at Week 24 of Treatment (US/China Approach)

For the US/China approach, the primary endpoint was the change from baseline in morning pre-dose trough FEV1 at Week 24 of treatment (NCT02343458)
Timeframe: at week 24

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug120
FF MDI 9.6 ug47
GP MDI 14.4 ug60
Placebo MDI-45

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TDI Focal Score Over 24 Weeks - US/China and EU/SK/TW Approaches -Symptomatic Population

TDI focal score over 24 Weeks as a Model-Based Average (ITT Population) The TDI is an instrument which measures the changes in the participant's dyspnea from Baseline. The scores in the TDI evaluate ratings for 3 different categories (functional impairment, magnitude of task in exertional capacity, and magnitude of effort). TDI scores ranged from -3 (major deterioration) to +3 (major improvement); total score = -9 to 9 (NCT02343458)
Timeframe: over 24 Weeks

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug1.5
FF MDI 9.6 ug1.3
GP MDI 14.4 ug1.1
Placebo MDI0.7

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TDI Focal Score Over 24 Weeks, US/China and EU/SK/TW Approach

TDI focal score over 24 Weeks as a Model-Based Average (ITT Population) The TDI is an instrument which measures the changes in the participant's dyspnea from Baseline. The scores in the TDI evaluate ratings for 3 different categories (functional impairment, magnitude of task in exertional capacity, and magnitude of effort). TDI scores ranged from -3 (major deterioration) to +3 (major improvement); total score = -9 to 9 (NCT02343458)
Timeframe: over 24 Weeks

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug1.6
FF MDI 9.6 ug1.5
GP MDI 14.4 ug1.3
Placebo MDI0.8

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TDI Focal Score Over Weeks 12-24 - Japan Approach - Symptomatic Population

TDI focal score over 12-24 Weeks as a Model-Based Average (ITT Population) The TDI is an instrument which measures the changes in the participant's dyspnea from Baseline. The scores in the TDI evaluate ratings for 3 different categories (functional impairment, magnitude of task in exertional capacity, and magnitude of effort). TDI scores ranged from -3 (major deterioration) to +3 (major improvement); total score = -9 to 9 (NCT02343458)
Timeframe: over weeks 12-24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug1.5
FF MDI 9.6 ug1.4
GP MDI 14.4 ug1.1
Placebo MDI0.7

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TDI Focal Score Over Weeks 12-24 Japan Approach

TDI focal score over 12-24 Weeks as a Model-Based Average (ITT Population) The TDI is an instrument which measures the changes in the participant's dyspnea from Baseline. The scores in the TDI evaluate ratings for 3 different categories (functional impairment, magnitude of task in exertional capacity, and magnitude of effort). TDI scores ranged from -3 (major deterioration) to +3 (major improvement); total score = -9 to 9 (NCT02343458)
Timeframe: over Weeks 12-24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug1.7
FF MDI 9.6 ug1.5
GP MDI 14.4 ug1.4
Placebo MDI0.8

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FEV1 Measured at 5 Minutes Post-dose on Day 1

Onset of Action as Assessed by FEV1 Day 1 at 5 Minutes Post-Dose. Reported is the FEV1 measured at 5 minutes post-dose on Day 1 as the first time point when the difference from Placebo was statistically significant (NCT02343458)
Timeframe: Assessed at 5-minutes post dose on Day 1

InterventionLiters (Least Squares Mean)
GFF MDI 14.4/9.6 ug0.202
FF MDI 9.6 ug0.186
GP MDI 14.4 ug0.059
Placebo MDI0.022

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Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing at Week 24 US/China Approach

Peak change from baseline in FEV1 within 2 hours post-dosing at Week 24 US/China approach (NCT02343458)
Timeframe: at week 24

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug358
FF MDI 9.6 ug247
GP MDI 14.4 ug214
Placebo MDI55

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Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over Weeks 12-24 Japan Approach

Peak change from baseline in FEV1 within 2 hours post-dosing over weeks 12-24 Japan approach (NCT02343458)
Timeframe: over weeks 12-24

InterventionmL (Least Squares Mean)
GFF MDI 14.4/9.6 ug368
FF MDI 9.6 ug255
GP MDI 14.4 ug228
Placebo MDI70

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FEV1 Measured at 15 Minutes Post-dose on Day 1

Onset of Action as Assessed by FEV1 Day 1 at 15 Minutes Post-Dose. Reported is the FEV1 measured at 15 minutes post-dose on Day 1 as the first time point when the difference from Placebo was statistically significant (NCT02343458)
Timeframe: Assessed at 15-minute post dose on Day 1

InterventionLiters (Least Squares Mean)
GFF MDI 14.4/9.6 ug0.241
FF MDI 9.6 ug0.220
GP MDI 14.4 ug0.105
Placebo MDI0.033

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Change From Baseline in SGRQ Total Score Over Weeks 12-24, in Symptomatic Population, Japan & EU/SK/TW Approach

Change from baseline in the SGRQ total score. The SGRQ is a disease-specific questionnaire, self-completed by participants, used to evaluate the effect of GFF MDI, FF MDI and GP MDI on health-related quality of life as compared to placebo in subjects with COPD. The scores range from 0 (minimum, best possible health status) to 100 (maximum, worst possible health status). The SGRQ contains 76 items grouped into three domains (symptoms, activity and impacts). Change from Baseline at a particular visit was calculated as the SGRQ total score at that visit minus Baseline. Change from Baseline in total score of -4 units or lower is considered as clinically meaningful improvement in quality of life (NCT02343458)
Timeframe: over weeks 12-24

InterventionScores on a scale (Least Squares Mean)
GFF MDI 14.4/9.6 ug-6.9
FF MDI 9.6 ug-7.3
GP MDI 14.4 ug-3.9
Placebo MDI-3.1

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Change From Baseline in Average Daily Rescue Ventolin Use Over 24 Weeks in RVU Population, All Approaches

Change from baseline in average daily rescue Ventolin use over 24 weeks in RVU population, all approaches (NCT02343458)
Timeframe: over 24 weeks

InterventionPuffs/day (Least Squares Mean)
GFF MDI 14.4/9.6 ug-1.4
FF MDI 9.6 ug-1.0
GP MDI 14.4 ug-0.6
Placebo MDI-0.4

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Morning Pre-Dose Trough FEV1 on Day 30

Morning Pre-Dose Trough FEV1 on Day 30 (NCT02347072)
Timeframe: Day 30

InterventionLiters (Least Squares Mean)
GFF MDI0.129
Spiriva Respimat0.072
Placebo-0.073

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Morning Pre-Dose Trough FEV1 on Day 29

Morning Pre-Dose Trough FEV1 on Day 29 (NCT02347072)
Timeframe: Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.140
Spiriva Respimat0.097
Placebo-0.020

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Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-24

Normalized Forced Expiratory Volume in 1 second (FEV1) Area Under the Curve (AUC) 0-24 (NCT02347072)
Timeframe: Pre dose, 15 and 30 minutes, 1, 2, 4, 8, 12, 12.25, 12.5, 13, 14, 16, 22, and 24 hours post the morning dose on Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.192
Spiriva Respimat0.112
Placebo-0.072

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FEV1 AUC0-12

Normalized FEV1 AUC0-12 (NCT02347072)
Timeframe: Pre dose, 15 and 30 minutes, 1, 2, 4, 8, and 12 hours post the morning dose on Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.226
Spiriva Respimat0.178
Placebo-0.026

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Peak Change From Baseline in FEV1 Morning

Peak Change From Baseline in FEV1 Morning (NCT02347072)
Timeframe: Baseline and Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.406
Spiriva Respimat0.325
Placebo0.129

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Peak Change From Baseline in IC (Inspiratory Capacity) Evening

Peak Change From Baseline in IC Evening (NCT02347072)
Timeframe: Baseline and Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.421
Spiriva Respimat0.297
Placebo0.109

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Peak Change From Baseline in IC Morning

Peak Change From Baseline in IC Morning (NCT02347072)
Timeframe: Baseline and Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.454
Spiriva Respimat0.374
Placebo0.206

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FEV1 AUC12-24

Normalized FEV1 AUC12-24 (NCT02347072)
Timeframe: Pre dose, 15 and 30 minutes, 1, 2, 4, 8, and 12 hours post the evening dose on Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.159
Spiriva Respimat0.039
Placebo-0.118

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Peak Change From Baseline in FEV1 Evening

Peak Change From Baseline in FEV1 Evening (NCT02347072)
Timeframe: Baseline and Day 29

InterventionLiters (Least Squares Mean)
GFF MDI0.395
Spiriva Respimat0.230
Placebo0.058

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Morning Pre-Dose Trough FEV1 on Day 29

Morning Pre-Dose Trough FEV on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.130
Placebo-0.012

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FEV1 AUC12-24 on Day 29

FEV1 AUC12-24 on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.115
Placebo-0.127

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FEV1 AUC0-24 on Day 29

Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC)0-24 on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.166
Placebo-0.083

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Peak Change From Baseline in Inspiratory Capacity (IC) Following the Evening Dose on Day 29

Peak Change from Baseline in Inspiratory Capacity (IC) following the evening dose on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.486
Placebo0.105

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Peak Change From Baseline in IC Following the Morning Dose on Day 29

Peak Change from Baseline in IC following the morning dose on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.543
Placebo0.208

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Peak Change From Baseline in FEV1 on Day 29

Peak Change From Baseline in FEV1 following the morning dose on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.410
Placebo0.134

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Peak Change From Baseline in FEV1 on Day 29

Peak Change From Baseline in FEV1 following evening Dose on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.344
Placebo0.050

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Morning Pre-Dose Trough FEV1 on Day 30

Morning Pre-Dose Trough FEV1 on Day 30 (NCT02347085)
Timeframe: Day 30

InterventionLiters (Mean)
GFF MD (PT003)0.090
Placebo-0.064

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FEV1 AUC0-12 on Day 29

FEV1 AUC0-12 on Day 29 (NCT02347085)
Timeframe: Day 29

InterventionLiters (Mean)
GFF MD (PT003)0.216
Placebo-0.039

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Change From Baseline in Area Under The Curve (AUC 0-12 Hour) for Forced Expiratory Volume in One Second (FEV1) Post Dosing at Day 1

The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) is assessed for 0-12 hour, post dosing at Day 1 of treatment. Baseline FEV1 was defined as the average of the -45 minutes and -15 minutes FEV1 values taken on Day 1. (NCT02371629)
Timeframe: Baseline, 0-12 hour post dose at Day 1

InterventionLiters (Least Squares Mean)
NVA237 Twice Daily0.143
NVA237 Once Daily0.139

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Change From Baseline in the Percentage of Days With no Rescue Medication Use Over the 26 Weeks

Patients report the number of puffs of rescue medication (salbutamol / albuterol) using an electronic diary. change from baseline in percentage of days without rescue medication usage over 26 weeks was analyzed. (NCT02371629)
Timeframe: Baseline, 26 Weeks

Interventionpercentage of days (Least Squares Mean)
NVA237 Twice Daily16.574
NVA237 Once Daily15.363

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Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Week 12

Spirometry testing was performed in accordance with American Thoracic Society standards. Trough FEV1 defined as the mean of two measurements at 23 hours 15 minutes and 23 hour 45 minutes post dosing. Baseline FEV1 was defined as the average of the -45 minutes and -15 minutes FEV1 values taken on Day 1. An analysis-of-covariance (ANCOVA) for repeated measurements, also known as mixed model for repeated measures (MMRM), was performed for the change from baseline of trough FEV1 at Week 12. The model included treatment, COPD severity, baseline smoking status, baseline ICS use, region, and visit (Day 1, and Weeks 12 and 26) as factors and baseline FEV1 as a covariate. (NCT02371629)
Timeframe: Baseline, Week 12

InterventionLiters (Least Squares Mean)
NVA237 Twice Daily0.092
NVA237 Once Daily0.059

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Change From Baseline in Area Under The Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) for Different Time Spans Post Dosing at Week 12

The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) is assessed for different time spans (0-12h, 0-24h, 12-24h) within the overall serial measurement post dosing at week 12 of treatment. Baseline FEV1 was defined as the average of the -45 minutes and -15 minutes FEV1 values taken on Day 1. (NCT02371629)
Timeframe: Baseline, 0-12 hour, 0-24 hour , 12-24 hour post dose at Week 12

,
InterventionLiters (Least Squares Mean)
AUC (0-12 hour)AUC (0-24 hour)AUC (12-24 hour)
NVA237 Once Daily0.1060.043-0.019
NVA237 Twice Daily0.1360.0850.035

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Change From Baseline in Area Under The Curve (AUC) for Forced Expiratory Volume in One Second (FEV1) for Different Time Spans Post Dosing at Week 26

The standardized Area Under the Curve (AUC) for Forced Expiratory Volume in one second (FEV1) is assessed for different time spans (0-12h, 0-24h, 12-24h) within the overall serial measurement post dosing at week 26 of treatment. Baseline FEV1 was defined as the average of the -45 minutes and -15 minutes FEV1 values taken on Day 1. (NCT02371629)
Timeframe: Baseline, 0-12 hour, 0-24 hour , 12-24 hour post dose at Week 26

,
InterventionLiters (Least Squares Mean)
AUC (0-12 hour)AUC (0-24 hour)AUC (12-24 hour)
NVA237 Once Daily0.0910.030-0.028
NVA237 Twice Daily0.1230.0760.032

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Change From Baseline in Forced Vital Capacity (FVC) at Individual Timepoints at Week 26

Mixed model for repeated measures was used to analyze change from baseline in FVC. Baseline FVC is defined as the average of the -45 min and -15 min FVC values taken on Day 1 prior to first dose. (NCT02371629)
Timeframe: Baseline, Week 26 (Day 183-184)

,
InterventionLiters (Least Squares Mean)
Day 183/-45 min:Day 183/-15 min:Day 183/5 min:Day 183/15 min:Day 183/30 min:Day 183/1 h:Day 183/2 hDay 183/3 h:Day 183/4 h:Day 183/6 hDay 183/8 hDay 183/10 hDay 183/12 hDay 183/13 hDay 184/16 hDay 184/22 hDay 184/23 h 15 minDay 184/23 h 45 min
NVA237 Once Daily0.0250.0290.0850.1320.1440.1540.2000.1860.1690.1160.0850.0390.0260.004-0.081-0.0760.0310.077
NVA237 Twice Daily0.0790.1020.1590.1770.1940.1900.2290.2290.2160.1460.1370.0710.0410.096-0.014-0.0360.0750.129

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Change From Baseline in Inspiratory Capacity (IC) at Individual Timepoints at Week 26

Mixed model for repeated measures was used to analyze change from baseline in IC. (NCT02371629)
Timeframe: Baseline, Week 26 (Day 183-184)

,
InterventionLiters (Least Squares Mean)
Day 183/-20 minDay 183/25 minDay 183/1 h 55 minDay 183/3 h 55 minDay 183/7 h 55 minDay 183/11 h 55 minDay 184/23 h 40 min
NVA237 Once Daily0.0540.1730.1710.1590.1100.0300.062
NVA237 Twice Daily0.0940.1810.1930.1630.1080.0420.045

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Change From Baseline in Mean Daily COPD Symptom Score at Week 26

Patients reported symptoms by using an electronic diary. The mean daily total symptom score, the mean morning symptom score and the mean evening symptom score were calculated for each patient over 26 weeks. Each symptom measured in a numeric rating scale of 0-10; 0 indicates no symptom and 10 indicates severe symptom. 0 is no waking due to symptoms, 1 woke up once, 2 woke up more than once due to symptoms ; 10 was the worst score.The daily score for an individual symptom score was the worst of the morning and evening scores on a particular day. If either the morning or evening score was missing for a symptom then the non-missing value was taken as the worst. A negative change indicates improvement. Only the scores for the 6 COPD symptoms (respiratory symptoms, cough, wheeze, production of sputum, sputum color, and breathlessness) were used to derive the total symptom score (NCT02371629)
Timeframe: Baseline, 26 Weeks

,
Interventionscore on a scale (Least Squares Mean)
Change in mean dailyChange in mean morningChange in mean evening
NVA237 Once Daily-1.107-0.828-1.056
NVA237 Twice Daily-1.336-1.032-1.205

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Change From Baseline in Total St. George's Respiratory Questionnaire (SGRQ) Score at Week 12 and Week 26

"The health status, as reported by the patients, is assessed using the St. George's Respiratory Questionnaire (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 caused 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 three subscales and the total score was calculated. In each case, the lowest possible value was 0 and the highest 100. Higher values corresponded to greater impairment of health status." (NCT02371629)
Timeframe: Baseline, 12 Weeks, 26 Weeks

,
Interventionscore on a scale (Least Squares Mean)
Change from Baseline to WK 12Change from Baseline to WK 26
NVA237 Once Daily-3.563-4.644
NVA237 Twice Daily-5.320-6.587

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Change From Baseline in Transitional Dyspnea Index (TDI) Focal Score at Week 12 and Week 26

Breathlessness at Week 12 and Week 26 is measured using the Transition Dyspnea Index (TDI). On day 1, breathlessness is assessed by the Baseline Dyspnea Index (BDI). Baseline Dyspnea Index (BDI)/Transition Dyspnea Index (TDI) focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. BDI was measured at day 1 prior to the first dose with domain scores ranging from 0=very severe to 4=no impairment and a total score ranging from 0 to 12(best). TDI captures changes from baseline. Each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. (NCT02371629)
Timeframe: Baseline, 12 Weeks, 26 Weeks

,
Interventionscore on a scale (Least Squares Mean)
Change from Baseline to WK 12Change from Baseline to WK 26
NVA237 Once Daily0.8491.170
NVA237 Twice Daily1.3461.523

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Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1) at Day 1 and Week 26

Spirometry testing was performed in accordance with American Thoracic Society standards. Trough FEV1 defined as the mean of two measurements at 23 hours 15 minutes and 23 hour 45 minutes post dosing. Baseline FEV1 was defined as the average of the -45 minutes and -15 minutes FEV1 values taken on Day 1. An analysis-of-covariance (ANCOVA) for repeated measurements, also known as mixed model for repeated measures (MMRM), was performed for the change from baseline of trough FEV1. The model included treatment, COPD severity, baseline smoking status, baseline ICS use, region, and visit (Day 1, and Weeks 12 and 26) as factors and baseline FEV1 as a covariate. (NCT02371629)
Timeframe: Baseline, Day 1, Week 26

,
InterventionLiters (Least Squares Mean)
Change from baseline to Day 1Change from baseline to Week 26
NVA237 Once Daily0.0700.056
NVA237 Twice Daily0.1190.104

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Number of Patients With Adverse Events, Serious Adverse Events and Death

This endpoint reports patients affected by any adverse events (AE), serious adverse events (SAE) and death. Only treatment emergent AE, SAE, deaths are reported for this endpoint. (NCT02371629)
Timeframe: 26 Weeks

,
InterventionCount of Participants (Number)
Patients with at least one AEPatients with at least one SAEDeath
NVA237 Once Daily224301
NVA237 Twice Daily203331

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Percentage of Patients With a Clinically Important Improvement on Transitional Dyspnea Index (TDI) Focal Score at Week 12 and Week 26

"Breathlessness at Week 12 and Week 26 is measured using the Transition Dyspnea Index (TDI). On day 1, breathlessness is assessed by the Baseline Dyspnea Index (BDI). Baseline Dyspnea Index (BDI)/Transition Dyspnea Index (TDI) focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. BDI was measured at day 1 prior to the first dose with domain scores ranging from 0=very severe to 4=no impairment and a total score ranging from 0 to 12(best). TDI captures changes from baseline. Each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score.~Clinically important improvement indicates ≥ 1 unit in the TDI focal score at Weeks 12 and 26 in comparison to BDI focal score (an increase of ≥ 1)." (NCT02371629)
Timeframe: Baseline, 12 Weeks, 26 Weeks

,
InterventionPercentage of patients (Number)
Change from Baseline to WK 12Change from Baseline to WK 26
NVA237 Once Daily52.054.6
NVA237 Twice Daily56.961.1

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Percentage of Patients With a Clinically Significant Improvement in St George Respiratory Questionnaire at Week 12 and Week 26

"The health status, as reported by the patients, is assessed using the St. George's Respiratory Questionnaire (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 caused 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 three subscales and the total score was calculated. In each case, the lowest possible value was 0 and the highest 100.~A clinically significant improvement is defined as ≥ 4 unit improvement from baseline score (a decrease of ≥ 4)." (NCT02371629)
Timeframe: Baseline, 12 Weeks, 26 Weeks

,
Interventionpercentage of patients (Number)
Change from Baseline to WK 12Change from Baseline to WK 26
NVA237 Once Daily46.949.6
NVA237 Twice Daily54.559.4

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Change From Baseline in Forced Expiratory Volume in One Second (FEV1) at Individual Timepoints at Week 26

Mixed model for repeated measures was used to analyze change from baseline in FEV1. Baseline FEV1 is defined as the average of the -45 min and -15 min FEV1 values taken on Day 1 prior to first dose. (NCT02371629)
Timeframe: Baseline, Week 26 (Day 183-184)

,
InterventionLiters (Least Squares Mean)
Day 183/-45 minDay 183/-15 minDay 183/5 minDay 183/15 minDay 183/30 minDay 183/1 hDay 183/2 hDay 183/3 hDay 183/4 hDay 183/6 hDay 183/8 hDay 183/10 hDay 183/12 hDay 183/13 hDay 184/16 hDay 184/22 hDay 184/23 h 15 minDay 184/23 h 45 min
NVA237 Once Daily0.0120.0340.0700.1060.1220.1320.1630.1540.1320.0800.0640.0380.0240.000-0.063-0.0430.0320.067
NVA237 Twice Daily0.0580.0860.1110.1450.1550.1580.1940.1790.1660.1100.1180.0670.0560.093-0.001-0.0120.0760.122

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Peak Change From Baseline in FEV1 Within 3 Hours Post-dosing on Day 15

Forced Expiratory Volume in 1 second (FEV1) within 3 hours post-dosing on Day 15 (NCT02433834)
Timeframe: From Day 1 to Within 3 hours post dosing on Day 15 in each of 5 treatment periods

InterventionLiter (Least Squares Mean)
GP MDI 28.8 µg0.284
GP MDI 14.4 µg0.261
GP MDI 7.2 µg0.252
GP MDI 3.6 µg0.237
GP MDI 1.9 µg0.215
Placebo MDI0.130
SAL 50 µg0.285

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Change From Baseline in Asthma Control Questionnaire (ACQ-5) on Day 15

The ACQ-5 measures 5 symptoms (woken at night by symptoms, wake in the morning with symptoms, limitation of daily activities, shortness of breath, and wheeze). The scale is 0-6, where 0=minimum and 6=maximum (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionScores on a scale (Least Squares Mean)
GP MDI 28.8 µg-0.167
GP MDI 14.4 µg-0.173
GP MDI 7.2 µg-0.113
GP MDI 3.6 µg-0.100
GP MDI 1.9 µg-0.205
Placebo MDI-0.056
SAL 50 µg-0.304

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FEV1 AUC0-3 on Day 15

FEV1 AUC0-3 is the area under the curve for the change from baseline in FEV1 calculated using the trapezoidal rule. All observed data will be used with the trapezoidal rule to calculate AUC. To aid in interpretation, all AUC values will be normalized by dividing the AUC by the time from the first to the last non-missing value (typically 3 hours). (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionLiter (Least Squares Mean)
GP MDI 28.8 µg0.191
GP MDI 14.4 µg0.167
GP MDI 7.2 µg0.146
GP MDI 3.6 µg0.147
GP MDI 1.9 µg0.113
Placebo MDI0.038
SAL 50 µg0.190

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Change From Baseline in Average Daily Post-dose PEFR Over 14 Days

Daily pre-dose PEFR and daily post-dose PEFR will each be calculated as the average of the AM and PM measurements recorded for a given day. If either the AM or PM assessment is missing, only the single measurement will be used. Analyses of average daily pre-dose PEFR, average daily post-dose PEFR, and rescue Ventolin HFA usage will use the average of the non-missing daily values recorded in the subject diaries over each week and over the last week of treatment within each period. (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionL/min (Least Squares Mean)
GP MDI 28.8 µg5.53
GP MDI 14.4 µg-2.86
GP MDI 7.2 µg-5.38
GP MDI 3.6 µg3.09
GP MDI 1.9 µg-5.68
Placebo MDI-21.65
SAL 50 µg3.55

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Change From Baseline in Average Daily Pre-dose PEFR Over 14 Days

Change from baseline in average daily pre-dose peak expiratory flow rate (PEFR) over 14 days Daily pre-dose PEFR and daily post-dose PEFR will each be calculated as the average of the AM and PM measurements recorded for a given day. If either the AM or PM assessment is missing, only the single measurement will be used. Analyses of average daily pre-dose PEFR, average daily post-dose PEFR, and rescue Ventolin HFA usage will use the average of the non-missing daily values recorded in the subject diaries over each week and over the last week of treatment within each period. (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionL/min (Least Squares Mean)
GP MDI 28.8 µg5.01
GP MDI 14.4 µg-6.54
GP MDI 7.2 µg-10.65
GP MDI 3.6 µg-2.98
GP MDI 1.9 µg-10.52
Placebo MDI-22.57
SAL 50 µg-3.00

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Change From Baseline in Average Daily Rescue Medication Use Over 14 Days

Daily pre-dose PEFR and daily post-dose PEFR will each be calculated as the average of the AM and PM measurements recorded for a given day. If either the AM or PM assessment is missing, only the single measurement will be used. Analyses of average daily pre-dose PEFR, average daily post-dose PEFR, and rescue Ventolin HFA usage will use the average of the non-missing daily values recorded in the subject diaries over each week and over the last week of treatment within each period. (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionPuffs (Least Squares Mean)
GP MDI 28.8 µg-0.42
GP MDI 14.4 µg-0.25
GP MDI 7.2 µg-0.24
GP MDI 3.6 µg-0.24
GP MDI 1.9 µg-0.23
Placebo MDI-0.11
SAL 50 µg-0.63

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Change From Baseline in Morning Pre-dose Trough FEV1 on Day 15

Change from baseline in morning pre-dose trough FEV1 on Day 15 (NCT02433834)
Timeframe: Day 1-Day 15 in each of 5 treatment periods

InterventionLiter (Least Squares Mean)
GP MDI 28.8 µg0.073
GP MDI 14.4 µg0.047
GP MDI 7.2 µg0.042
GP MDI 3.6 µg0.012
GP MDI 1.9 µg0.018
Placebo MDI-0.012
SAL 50 µg0.059

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Change From Baseline in FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 4 hour intervals FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h. (NCT02487446)
Timeframe: baseline, 12 weeks

,
InterventionLiter (Least Squares Mean)
0-4h4-8h8-12h12-16h16-20h20-24h (n=310,314)
QVA1490.32230.23990.19110.25940.19140.1722
Umeclidinium/Vilanterol0.32890.28310.24110.23490.18750.1821

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Change From Baseline in FEV1 AUC 0-12h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 12 hours (AUC 0-12h). (NCT02487446)
Timeframe: baseline, 0 to 12 hours post-dose at week 12

InterventionLiter (Least Squares Mean)
QVA1490.2543
Umeclidinium/Vilanterol0.2848

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Change From Baseline in Pre-dose Trough FEV1 (Mean of 15 Minutes and 45 Minutes Pre Morning Dose)

FEV1 was measured with spirometry conducted according to internationally accepted standards. Pre-dose trough FEV1 was defined as the average of measurements made 15 minutes and 45 minutes pre morning dose for each treatment. (NCT02487446)
Timeframe: baseline, 15 minutes and 45 minutes pre morning dose at week 12

InterventionLiter (Least Squares Mean)
QVA1490.2302
Umeclidinium/Vilanterol0.2450

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Change From Baseline in Forced Expiratory Volume (FEV1) Area Under the Curve (AUC) 0-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 0-24h). A positive change from baseline indicates improvement. (NCT02487446)
Timeframe: baseline, 0 to 24 hours post-dose at week 12

,
InterventionLiters (Least Squares Mean)
QVA1490.2321
Umeclidinium/Vilanterol0.2436
QVA1490.2321
Umeclidinium/Vilanterol0.2436

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Change From Baseline in FEV1 AUC 12-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 12 hours (AUC 12-24h). (NCT02487446)
Timeframe: baseline, 12 hours to 24 hours post-dose at week 12

InterventionLiters (Least Squares Mean)
QVA1490.2076
Umeclidinium/Vilanterol0.2025

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QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Forced Vital Capacity (FVC) at Any Time Point

FEV1 was measured with spirometry conducted according to internationally accepted standards. (NCT02487446)
Timeframe: Day 1 (5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 23h 15min, 23h 45min); week 6 (-45min, -15min); week 12 (-45min, -15min, 5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 12h 5min, 12h 15min, 12h 30min, 13, 14, 16, 20, 23h 15min, 23h 45min)

,
InterventionLiter (Least Squares Mean)
Day 1, 5 minutesDay 1, 15 minutesDay 1, 30 minutesDay 1, 1 hourDay 1, 2 hoursDay 1, 4 hoursDay 1, 8 hoursDay 1, 11 hours 55 minutesDay 1, 23 hours 15 minutesDay 1, 23 hours 45 minutesWeek 6, -45 minutesWeek 6, -15 minutesWeek 12, -45 minutesWeek 12, -15 minutesWeek 12, 5 minutesWeek 12, 15 minutesWeek 12, 30 minutesWeek 12, 1 hourWeek 12, 2 hoursWeek 12, 4 hoursWeek 12, 8 hoursWeek 12, 11 hours 55 minutesWeek 12, 12 hours 5 minutes (n=294,305)Week 12, 12 hours 15 minutesWeek 12, 12 hours 30 minutesWeek 12, 13 hoursWeek 12, 14 hoursWeek 12, 16 hoursWeek 12, 20 hoursWeek 12, 23 hours 15 minutesWeek 12, 23 hours 45 minutes (n=300,303)
QVA1490.21770.25660.28110.29440.31090.27880.16810.14060.25650.27370.29140.33900.30440.33440.39600.43780.46020.46490.44050.38720.27140.23060.34550.34090.36880.37600.36810.31290.21750.22370.2607
Umeclidinium/Vilanterol0.22180.29270.33250.35340.36870.42370.32370.29100.27470.30010.35130.37320.34420.35660.38610.41690.44800.46470.48530.43430.35550.32310.31120.32350.33260.33610.33710.32790.23530.27500.2728

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QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in FEV1 at Any Time Point

FEV1 was measured with spirometry conducted according to internationally accepted standards. (NCT02487446)
Timeframe: Day 1 (5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 23h 15min, 23h 45min); week 6 (-45min, -15min); week 12 (-45min, -15min, 5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 12h 5min, 12h 15min, 12h 30min, 13, 14, 16, 20, 23h 15min, 23h 45min)

,
InterventionLiter (Least Squares Mean)
Day 1, 5 minutesDay 1, 15 minutesDay 1, 30 minutesDay 1, 1 hourDay 1, 2 hoursDay 1, 4 hoursDay 1, 8 hoursDay 1, 11 hours 55 minutesDay 1, 23 hours 15 minutesDay 1, 23 hours 45 minutesWeek 6, -45 minutesWeek 6, -15 minutesWeek 12, -45 minutesWeek 12, -15 minutesWeek 12, 5 minutesWeek 12, 15 minutesWeek 12, 30 minutesWeek 12, 1 hourWeek 12, 2 hoursWeek 12, 4 hoursWeek 12, 8 hoursWeek 12, 11 hours 55 minutesWeek 12, 12 hours 5 minutesWeek 12, 12 hours 15 minutesWeek 12, 12 hours 30 minutesWeek 12, 13 hoursWeek 12, 14 hoursWeek 12, 16 hoursWeek 12, 20 hoursWeek 12, 23 hours 15 minutes (n=299,305)Week 12, 23 hours 45 minutes
QVA1490.11120.15090.16020.17550.18400.14320.08150.06990.14980.15790.21220.23780.22250.23900.28790.31870.33460.34260.33430.27600.20330.17640.23430.24650.26950.27490.26670.22300.16220.17910.2048
Umeclidinium/Vilanterol0.12010.16820.19450.22300.23290.22700.18610.16740.17640.19320.24690.26680.23780.25380.28310.30740.32580.33340.34450.31370.25450.23110.22180.23240.23500.24480.23550.21970.16290.19810.2117

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Change From Baseline in FEV1 AUC 0-12h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 12 hours (AUC 0-12h). (NCT02487498)
Timeframe: baseline, 0 to 12 hours post-dose at week 12

InterventionLiters (Least Squares Mean)
First QVA149, Then Umeclidinium/Vilanterol0.2077
First Umeclidinium/Vilanterol, Then QVA1490.2496

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Change From Baseline in FEV1 AUC 12-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 12 hours (AUC 12-24h). (NCT02487498)
Timeframe: baseline, 12 hours to 24 hours post-dose at week 12

InterventionLiters (Least Squares Mean)
First QVA149, Then Umeclidinium/Vilanterol0.1625
First Umeclidinium/Vilanterol, Then QVA1490.1539

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Change From Baseline in Forced Expiratory Volume (FEV1) Area Under the Curve (AUC) 0-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 0-24h). A positive change from baseline indicates improvement. (NCT02487498)
Timeframe: baseline, 0 to 24 hours post-dose at week 12

,
InterventionLiters (Least Squares Mean)
First QVA149, Then Umeclidinium/Vilanterol0.1846
First Umeclidinium/Vilanterol, Then QVA1490.2028
First QVA149, Then Umeclidinium/Vilanterol0.1846
First Umeclidinium/Vilanterol, Then QVA1490.2028

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QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Pre-dose Trough FEV1 (Mean of 15 Minutes and 45 Minutes Pre Morning Dose)

FEV1 was measured with spirometry conducted according to internationally accepted standards. Pre-dose trough FEV1 was defined as the average of measurements made 15 minutes and 45 minutes pre morning dose for each treatment. (NCT02487498)
Timeframe: baseline, 12 weeks

InterventionLiters (Least Squares Mean)
First QVA149, Then Umeclidinium/Vilanterol0.1827
First Umeclidinium/Vilanterol, Then QVA1490.2043

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Change From Baseline in FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h

FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over 4 hour intervals FEV1 AUC 0-4h, AUC 4-8h, AUC 8-12h, AUC 12-16h, AUC 16-20h and AUC 20-24h. (NCT02487498)
Timeframe: baseline, 12 weeks

,
InterventionLiter (Least Squares Mean)
0-4h4-8h8-12h12-16h16-20h20-24h
First QVA149, Then Umeclidinium/Vilanterol0.26630.19700.15130.21200.13830.1374
First Umeclidinium/Vilanterol, Then QVA1490.29380.25190.20150.18420.13400.1445

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QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in FEV1 at Any Time Point

FEV1 was measured with spirometry conducted according to internationally accepted standards. (NCT02487498)
Timeframe: Day 1 (5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 23h 15min, 23h 45min); week 6 (-45min, -15min); week 12 (-45min, -15min, 5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 12h 5min, 12h 15min, 12h 30min, 13, 14, 16, 20, 23h 15min, 23h 45min)

,
InterventionLiters (Least Squares Mean)
Day 1, 5 minutesDay 1, 15 minutesDay 1, 30 minutesDay 1, 1 hourDay 1, 2 hoursDay 1, 4 hoursDay 1, 8 hoursDay 1, 11 hours 55 minutesDay 1, 23 hours 15 minutesDay 1, 23 hours 45 minutesWeek 6, -45 minutesWeek 6, -15 minutesWeek 12, -45 minutesWeek 12, -15 minutesWeek 12, 5 minutesWeek 12, 15 minutesWeek 12, 30 minutesWeek 12, 1 hourWeek 12, 2 hoursWeek 12, 4 hoursWeek 12, 8 hoursWeek 12, 11 hours 55 minutesWeek 12, 12 hours 5 minutesWeek 12, 12 hours 15 minutesWeek 12, 12 hours 30 minutesWeek 12, 13 hoursWeek 12, 14 hoursWeek 12, 16 hoursWeek 12, 20 hoursWeek 12, 23 hours 15 minutesWeek 12, 23 hours 45 minutes
First QVA149, Then Umeclidinium/Vilanterol0.11340.14480.16300.17420.17230.14870.09080.05210.14220.17020.18190.21110.17500.19140.24210.26810.28190.29190.27400.23160.16310.13200.19740.21070.22960.23410.23080.17050.10780.15730.1798
First Umeclidinium/Vilanterol, Then QVA1490.11170.15910.18360.20000.21380.21680.17810.15370.15730.18210.20710.23430.19570.21120.25630.28650.29400.30530.29940.28230.22010.18120.18930.19590.19340.19530.19660.15820.11580.16480.1892

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QVA149 Compared to Umeclidinium/Vilanterol in Terms of Change From Baseline in Forced Vital Capacity (FVC) at Any Time Point

FEV1 was measured with spirometry conducted according to internationally accepted standards. (NCT02487498)
Timeframe: Day 1 (5min, 15min, 30 min, hours 1, 2, 4, 8, 11h 55min, 23h 15min, 23h 45min); week 6 (-45min, -15min); week 12 (-45min, -15min, 5min, 15min, 30min, hours 1, 2, 4, 8, 11h 55min, 12h 5min, 12h 15min, 12h 30min, 13, 14, 16, 20, 23h 15min, 23h 45min)

,
InterventionLiters (Least Squares Mean)
Day 1, 5 minutesDay 1, 15 minutesDay 1, 30 minutesDay 1, 1 hourDay 1, 2 hoursDay 1, 4 hoursDay 1, 8 hoursDay 1, 11 hours 55 minutesDay 1, 23 hours 15 minutesDay 1, 23 hours 45 minutesWeek 6, -45 minutesWeek 6, -15 minutesWeek 12, -45 minutesWeek 12, -15 minutesWeek 12, 5 minutesWeek 12, 15 minutesWeek 12, 30 minutesWeek 12, 1 hourWeek 12, 2 hoursWeek 12, 4 hoursWeek 12, 8 hoursWeek 12, 11 hours 55 minutesWeek 12, 12 hours 5 minutesWeek 12, 12 hours 15 minutesWeek 12, 12 hours 30 minutesWeek 12, 13 hoursWeek 12, 14 hoursWeek 12, 16 hoursWeek 12, 20 hoursWeek 12, 23 hours 15 minutesWeek 12, 23 hours 45 minutes
First QVA149, Then Umeclidinium/Vilanterol0.19940.24540.27340.28410.27080.23330.17280.12910.23870.28210.26660.28600.22640.24680.33860.36160.37960.39350.37080.32610.22590.19000.28170.30100.32790.33810.34450.24960.16000.20260.2415
First Umeclidinium/Vilanterol, Then QVA1490.20540.25890.30280.31360.33340.34050.30670.26540.23630.29400.30450.33720.27370.28440.34890.38110.40190.40850.40500.38450.31520.27490.27110.27620.27860.29090.29840.25140.18450.22510.2662

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Apparent Volume of Distribution (Vz/F) After Extravascular Dose Administration of Seebri Breezhaler and SUN-101

"calculated as Dose/(AUC0-∞* λz), where F = Bioavailability. If AUC0-∞ is missing, then Vz/F is considered as missing.~Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr" (NCT02512302)
Timeframe: up to week 5

Interventionliters (Geometric Mean)
SUN-101 Via eFlow Nebulizer1263.63
SUN-101 Via eFlow Nebulizer With Activated Charcoal1668.59
Seebri® Breezhaler®1305.30
Seebri® Breezhaler® With Activated Charcoal1708.81

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Area Under the Curve From Time Zero to 24 Hours (AUC0_24)

Area under the drug concentration-time curve from time zero to 24 hours postdose pk parameteres are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr (NCT02512302)
Timeframe: Up to Week 5

Interventionhr*pg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer172.23
SUN-101 Via eFlow Nebulizer With Activated Charcoal159.12
Seebri® Breezhaler®472.35
Seebri® Breezhaler® With Activated Charcoal428.52
: Glycopyrrolate Injection1961.79

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Area Under the Curve Zero to 48 Hours (AUC0_48) for Seebri Breezhaler and Sun-101 AUC0-48, CL/F, Vz/F, Tmax, t½, and Dose Normalized Cmax, AUC0-24, AUC0-48, AUC0-∞ - AUC0-∞ -

Area under the drug concentration-time curve from time zero to 48 hours postdose Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr. (NCT02512302)
Timeframe: Up to Week 5

Interventionhr*pg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer182.59
SUN-101 Via eFlow Nebulizer With Activated Charcoal179.78
Seebri® Breezhaler®524.18
Seebri® Breezhaler® With Activated Charcoal485.99

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Clearance (CL) for IV Infusion of 50 mcg of Glycopyrrolate

"calculated as Dose/AUC0-inf after the IV dose administration. If AUC0-inf is missing, then CL was considered as missing.~Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr." (NCT02512302)
Timeframe: Up to Week 5

InterventionLiters/hr (Geometric Mean)
: Glycopyrrolate Injection19.60

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Cmax

maximum observed concentration-Cmax is calculated from plasma concentrations analyzed from blood samples collected between 0 and 48 hr. (NCT02512302)
Timeframe: Up to Week 5

InterventionPg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer53.75
SUN-101 Via eFlow Nebulizer With Activated Charcoal49.27
Seebri® Breezhaler®166.79
Seebri® Breezhaler® With Activated Charcoal148.03
: Glycopyrrolate Injection3787.47

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Time of Occurrence of Cmax (Tmax) for IV Infusion of 50 mcg of Glycopyrrolate

The time 0 is based on start of the infusion. Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr. (NCT02512302)
Timeframe: Up to Week 5

Interventionhr (Median)
: Glycopyrrolate Injection0.100

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Dose Normalized Area Under the Curve Zero From Zero to Infinity (AUC0_inf) for Seebri and SUN-101

"Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr.~Area under the drug concentration-time curve from zero to infinity, calculated by summing AUC0-last and the AUC extrapolated from tlast to infinity multiplied by the dose normalization factor: dose normalization factor* (AUC0-∞ = AUC0-last+ Clast / (NCT02512302)
Timeframe: λz

Intervention λz ( ) Clast / )
SUN-101 Via eFlow Nebulizer λz
SUN-101 Via eFlow Nebulizer With Activated Charcoal λz
Seebri® Breezhaler® λz
Seebri® Breezhaler® With Activated Charcoal λz

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Dose Normalized Area Under the Curve Zero to 48 Hours (AUC0_48) for Seebri and SUN-101

"Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr.~Area under the drug concentration-time curve from time zero to 48 hours postdose multiplied by the dose normalization factor. The dose normalization factor calculation has two components: dose equivalent glycopyrrolate amount and the delivery efficiency (% dose delivered). For Sun-101 50 mcg, the dose normalization factor is 1.59, for Seebri Breezhaler it is 0.9." (NCT02512302)
Timeframe: up to week 5

Interventionhr*pg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer290.32
SUN-101 Via eFlow Nebulizer With Activated Charcoal285.85
Seebri® Breezhaler®471.76
Seebri® Breezhaler® With Activated Charcoal437.39

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Dose Normalized Cmax for Seebri and SUN-101.

"Maximum observed concentration multiplied by the dose normalization factor. Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr.~The dose normalization factor calculation has two components: dose equivalent glycopyrrolate amount and the delivery efficiency (% dose delivered). For Sun-101 50 mcg, the dose normalization factor is 1.59, for Seebri Breezhaler it is 0.9." (NCT02512302)
Timeframe: up to week 5

InterventionPg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer85.46
SUN-101 Via eFlow Nebulizer With Activated Charcoal78.33
Seebri® Breezhaler®150.11
Seebri® Breezhaler® With Activated Charcoal133.22

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Area Under the Curve From Time Zero to Infinity (AUC0_infinity)

"calculated by summing AUC0-last and the AUC extrapolated from tlast to infinity: AUC0-∞ = AUC0-last+ Clast / (NCT02512302)
Timeframe: λz

Intervention λz ( Clast / )
SUN-101 Via eFlow Nebulizer λz
SUN-101 Via eFlow Nebulizer With Activated Charcoal λz
Seebri® Breezhaler® λz
Seebri® Breezhaler® With Activated Charcoal λz
: Glycopyrrolate Injection λz

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Dose Normalized Area Under the Curve Zero to 24 Hours (AUC0_24) for Seebri and SUN-101

"Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr.~Area under the drug concentration-time curve from time zero to 24 hours postdose multiplied by the dose normalization factor. The dose normalization factor calculation has two components: dose equivalent glycopyrrolate amount and the delivery efficiency (% dose delivered). For Sun-101 50 mcg, the dose normalization factor is 1.59, for Seebri Breezhaler it is 0.9." (NCT02512302)
Timeframe: up to week 5

Interventionhr*pg/mL (Geometric Mean)
SUN-101 Via eFlow Nebulizer273.85
SUN-101 Via eFlow Nebulizer With Activated Charcoal253.00
Seebri® Breezhaler®425.12
Seebri® Breezhaler® With Activated Charcoal385.67

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The Percentage of Subjects With Adverse Events (AEs), Serious Adverse Events (SAEs), and AEs Leading to Discontinuation

An adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02512302)
Timeframe: Up to Week 5

,,,,
Interventionpercentage of participants (Number)
Adverse EventsSerious Adverse EventsAdverse events leading to discontinuation
: Glycopyrrolate Injection25.900
Seebri® Breezhaler®25.000
Seebri® Breezhaler® With Activated Charcoal40.703.7
SUN-101 Via eFlow Nebulizer20.703.4
SUN-101 Via eFlow Nebulizer With Activated Charcoal31.003.4

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The Number of Subjects With Adverse Events (AEs), Serious Adverse Events (SAEs), and AEs Leading to Discontinuation

An adverse event (AE) that occurred on or after the first dose of study medication, any AE with a missing start date and a stop date on or after the first dose of study medication, or any AE with both a missing start and stop date. (NCT02512302)
Timeframe: Up to Week 5

,,,,
Interventionparticipants (Number)
Adverse EventsSerious Adverse EventsAdverse events leading to discontinuation
: Glycopyrrolate Injection700
Seebri® Breezhaler®700
Seebri® Breezhaler® With Activated Charcoal1101
SUN-101 Via eFlow Nebulizer601
SUN-101 Via eFlow Nebulizer With Activated Charcoal901

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Time of Occurrence of Cmax (Tmax) for Seebri Breezhaler and SUN-101

The time 0 is based on start of the inhalation. Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr. (NCT02512302)
Timeframe: up to week 5

Interventionhr (Median)
SUN-101 Via eFlow Nebulizer0.317
SUN-101 Via eFlow Nebulizer With Activated Charcoal0.250
Seebri® Breezhaler®0.250
Seebri® Breezhaler® With Activated Charcoal0.250

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Volume of Distribution During the Elimination Phase (Vz) for IV Infusion of 50 mcg of Glycopyrrolate

calculated as Dose/(AUC0-inf*λz). Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr. (NCT02512302)
Timeframe: Up to Week 5

InterventionLiters (Geometric Mean)
: Glycopyrrolate Injection113.06

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Terminal Half Life (t1/2) for for Seebri Breezhaler and SUN-101

"calculated as ln(2) / λz . At least 3 data points at the terminal elimination phase were required to determine t½.~Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr." (NCT02512302)
Timeframe: up to week 5

Interventionhr (Geometric Mean)
SUN-101 Via eFlow Nebulizer6.554
SUN-101 Via eFlow Nebulizer With Activated Charcoal5.191
Seebri® Breezhaler®10.378
Seebri® Breezhaler® With Activated Charcoal14.866

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Terminal Half Life (t1/2) for IV Infusion of 50 mcg of Glycopyrrolate

"calculated as ln(2) / λz . At least 3 data points at the terminal elimination phase were required to determine t½.~Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr." (NCT02512302)
Timeframe: Up to Week 5

Interventionhr (Geometric Mean)
: Glycopyrrolate Injection3.998

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Apparent Clearance Calculated as Dose/AUC0-INF After Extravascular Dose Administration of Seebri Breezhaler and SUN-101

"calculated as Dose/AUC0-∞ after extravascular dose administration, where F = Bioavailability. If AUC0-∞ is missing, then CL/F is considered as missing.~Pk parameters are calculated from plasma concentration analyzed from blood samples collected between 0 and 48 hr." (NCT02512302)
Timeframe: up to week 5

InterventionL/hr (Geometric Mean)
SUN-101 Via eFlow Nebulizer213.47
SUN-101 Via eFlow Nebulizer With Activated Charcoal297.91
Seebri® Breezhaler®103.70
Seebri® Breezhaler® With Activated Charcoal110.35

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Central Command Regulation of Heart Rate

Heart rate response to static hand grip immediately followed by supra-systolic arm occlusion and release will determine adequacy on central command control over heart rate response during exercise. (NCT02524145)
Timeframe: 1 day; primary outcome was complete for each subject in 1 day

Interventionbeats per minute (Mean)
Healthy Seniors93
HFpEF89

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Cardiac Beta-receptor Sensitivity

Cardiac beta-receptor sensitivity will be measured by calculating slope of heart rate versus isoproterenol serum level. (NCT02524145)
Timeframe: 1 day; primary outcome was complete for each subject in 1 day

Interventionbeats per ng/kg/min ISO (Mean)
Healthy Seniors0.254
HFpEF0.156
Healthy Young0.365

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Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4

(NCT02530281)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium72.4
Vehicle53.2

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Percentage of Subjects Who Have a ≥2 Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS) From Baseline at Week 4

"Hyperhidrosis Disease Severity Scale (HDSS) is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities.~1 (Best), 2, 3, 4 (Worst)" (NCT02530281)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium56.5
Vehicle23.7

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Median Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4

(NCT02530281)
Timeframe: From Baseline to Week 4

Interventionmg/5 min (Median)
Glycopyrronium-80.79
Vehicle-65.81

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Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4, Excluding Centers With Outlier Data

(NCT02530281)
Timeframe: Baseline - Week 4

Interventionmg/5 min (Least Squares Mean)
Glycopyrronium-100.56
Vehicle-88.08

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Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4

Subjects are acclimated to the environment for 30 minutes. Dry gauze is weighed. The dry gauze is then applied to the subject's axilla with the arm down by the subject's side or on their lap during the 5-minute period of sweat production. The gauze with the sweat is then weighed. The difference between the Weight of the gauze with sweat and the dry gauze is the gravimetric sweat measurement in mg/5min. (NCT02530281)
Timeframe: From Baseline to Week 4

Interventionmg/5 min (Least Squares Mean)
Glycopyrronium-102.00
Vehicle-100.34

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Percentage of Subjects Who Have a ≥4-point Improvement in the Weekly Mean Score of ASDD Item #2 From Baseline at Week 4

"The Axillary Sweating Daily Diary (ASDD) is a 4-item instrument designed to measure the severity of axillary hyperhidrosis and its impact on daily activities. The 4 Items are:~During the past 24 hours, did you have any underarm sweating? (Yes or No)~During the past 24 hours, how would you rate your underarm sweating at its worst? (0=No sweating at all, 1, 2,…, 10=Worst possible sweating)~During the past 24 hours, to what extent did your underarm sweating impact your activities? (0=Not at all, 1=A little bit, 2=A moderate amount, 3=A great deal and 4=An extreme amount)~During the past 24 hours, how bothered were you by your underarm sweating? (0=Not at all bothered, 1=A little bothered, 2=Moderately bothered, 3=Very bothered, 4=Extremely bothered)" (NCT02530281)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium52.8
Vehicle28.3

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Median Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4

(NCT02530294)
Timeframe: From Baseline to Week 4

Interventionmg/5 min (Median)
Glycopyrronium-78.77
Vehicle-57.94

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Percentage of Subjects Who Have a ≥2 Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS) From Baseline at Week 4

Hyperhidrosis Disease Severity Scale (HDSS) is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities. (NCT02530294)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium61.6
Vehicle27.8

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Percentage of Subjects Who Have a ≥4-point Improvement in the Weekly Mean Score of Axillary Sweating Daily Diary (ASDD) Item #2 From Baseline at Week 4

"The Axillary Sweating Daily Diary (ASDD) is a 4-item instrument designed to measure the severity of axillary hyperhidrosis and its impact on daily activities. The 4 Items are:~During the past 24 hours, did you have any underarm sweating? (Yes or No)~During the past 24 hours, how would you rate your underarm sweating at its worst? (0=No sweating at all, 1, 2,…, 10=Worst possible sweating)~During the past 24 hours, to what extent did your underarm sweating impact your activities? (0=Not at all, 1=A little bit, 2=A moderate amount, 3=A great deal and 4=An extreme amount)~During the past 24 hours, how bothered were you by your underarm sweating? (0=Not at all bothered, 1=A little bothered, 2=Moderately bothered, 3=Very bothered, 4=Extremely bothered)" (NCT02530294)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium66.1
Vehicle26.9

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Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically Measured Sweat Production From Baseline at Week 4

(NCT02530294)
Timeframe: From Baseline to Week 4

Interventionpercent of subjects (Number)
Glycopyrronium77.3
Vehicle53.3

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Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4

Subjects are acclimated to the environment for 30 minutes. Dry gauze is weighed. The dry gauze is then applied to the subject's axilla with the arm down by the subject's side or on their lap during the 5-minute period of sweat production. The gauze with the sweat is then weighed. The difference between the Weight of the gauze with sweat and the dry gauze is the gravimetric sweat measurement in mg/5min. (NCT02530294)
Timeframe: Baseline - Week 4

Interventionmg/5 min (Least Squares Mean)
Glycopyrronium-115.43
Vehicle-81.20

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Change From Baseline in Dermatology Life Quality Index (DLQI) at Week 44/ET

The Dermatology Life Quality Index DLQI is a ten question questionnaire, used to measure the impact of skin disease on the quality of life of an affected person. The scoring of each question is as follows: Very much (3), A lot (2), A little (1), Not at all (0), Not relevant (0). Is calculated by summing the score of each question resulting in a max of 30 and a min of 0. Higher the score the more Quality of life is impaired. (NCT02553798)
Timeframe: Baseline (from DRM04-HH04 (NCT02530281) or DRM04-HH05 (NCT02530294) study) - Week 44/ET

Interventionscores on a scale (Mean)
Glycopyrronium-8.7

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Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 4

Subjects are acclimated to the environment for 30 minutes. Dry gauze is weighed. The dry gauze is then applied to the subject's axilla with the arm down by the subject's side or on their lap during the 5-minute period of sweat production. The gauze with the sweat is then weighed. The difference between the Weight of the gauze with sweat and the dry gauze is the gravimetric sweat measurement in mg/5min. (NCT02553798)
Timeframe: Baseline (from DRM04-HH04 (NCT02530281) or DRM04-HH05 (NCT02530294) study) - Week 44/ET

Interventionmg/5 min (Mean)
Glycopyrronium-95.68

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Long-term Safety Assessed Through Adverse Events and Local Skin Reactions

The Total Participants at risk are based on the Safety population, defined as, Participants who were randomized and received at least one confirmed dose of study drug. (NCT02553798)
Timeframe: Day 1 - Week 44

InterventionAdverse Events and Local Skin Reactions (Number)
Mild AEsModerate AEsSevere AEsMild LSRsModerate LSRsSevere LSRs
Glycopyrronium148153281204415

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Grade Improvement in Hyperhidrosis Disease Severity Scale (HDSS)

Hyperhidrosis Disease Severity Scale (HDSS) is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities. (NCT02553798)
Timeframe: Baseline (from DRM04-HH04 (NCT02530281) or DRM04-HH05 (NCT02530294) study) - Week 44/ET

Interventionparticipants (Number)
3 - point improvement2 - point improvement1 - point improvementno improvement
Glycopyrronium7220413526

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Baseline Transitional Dyspnea Index (TDI) Focal Score

A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing). TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. TDI captures changes from baseline, each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score. (NCT02566031)
Timeframe: Week 12

InterventionScore (Mean)
Indacaterol and Glycopyrronium (QVA149)0.77
Tiotropium0.61

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Daily Rescue Medication Use (Number of Puffs)

The total number of puffs of rescue medication used over the last 24 hours will be recorded in the patient diary in the morning. The total number of puffs of rescue medication per day over the full 12 weeks will be calculated and divided by the total number of days with non-missing rescue medication data to derive the mean daily number of puffs of rescue medication taken for the patient. The mean daily number of puffs of rescue medication used over 12 weeks will be summarized by treatments (NCT02566031)
Timeframe: Week 12

InterventionPuffs/day (Mean)
Indacaterol and Glycopyrronium (QVA149)1.7
Tiotropium1.8

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Trough Forced Expiratory Volume In One Second (FEV1) After 12 Weeks of Treatment

Spirometry was performed according to internationally accepted standards. Trough FEV1 is defined as the mean of 45 minute and 15 minute pre-dose values. (NCT02566031)
Timeframe: Week 12

InterventionLiters (Mean)
Indacaterol and Glycopyrronium (QVA149)0.0668
Tiotropium0.0090

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Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)

Total score of COPD Assessment Test (CAT) will be measured at week 12. This questionnaire is completed by the patient. The score ranges from 0-40 where higher scores represent worse health status. Mild: Score = 0 - 10, Moderate: Score = 11 - 20, Severe: Score = 21 - 30, Very Severe: Score = 31 - 40. The CAT total score was the sum of 8 item scores (each ranging from 0 to 5). If 1 or 2 items were missing, they were replaced with the mean of the completed items. If 3 or more items were missing, the CAT total score was set missing (NCT02566031)
Timeframe: Week 12

,
InterventionNumber of participants (Number)
MildModerateSevereVery severeMissing
Indacaterol and Glycopyrronium (QVA149)62921508
Tiotropium541012216

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Trough Forced Expiratory Volume In One Second (FEV1) After 4 Weeks of Treatment

Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the mean of 45 minute and 15 minute pre-dose values. (NCT02566031)
Timeframe: mean of 45 min and 15 min pre-dose week 4

,
InterventionLiters (Mean)
-45min-15min
Indacaterol and Glycopyrronium (QVA149)0.0870.077
Tiotropium0.0260.024

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Depth and Duration of Intraoperative Hypotension - Threshold MAP 75 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group485
Hypotension Decision Support417

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Usage Frequency of Cardiovascular Drugs: Ephinephrine

Cardiovascular drugs as defined under interventions. Frequency of patients receiving the drug. Cardiovascular drugs that were given in <1% of cases are not reported. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group1215
Hypotension Decision Support409

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Usage Frequency of Cardiovascular Drugs: Ephedrine

Cardiovascular drugs as defined under interventions. Frequency of patients receiving the drug. Cardiovascular drugs that were given in <1% of cases are not reported. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group9310
Hypotension Decision Support2718

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Timing of Cardiovascular Drugs for MAP < 65 mmHg

Cardiovascular drugs as defined under interventions. Time of first administration of cardiovascular drug relative to the time at which the mean arterial pressure (MAP) drops below 60 mmHg. Per patient the average time to first administration of all hypotensive episodes was calculated. That average time is used as the outcome variable. A negative value indicates that administration occurred before the drop in MAP. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionminutes (Median)
Usual Care Group2
Hypotension Decision Support1.14

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Postoperative Rise in Creatinine Levels

Absolute values for serum creatinine before and after surgery will be compared. When multiple postoperative creatinine measurements are made, the maximum difference is reported. (NCT02726620)
Timeframe: Within 7 days after surgery

Interventionmg/dL (Median)
Usual Care Group0.00
Hypotension Decision Support0.00

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Time to Discharge Readiness at the Postanesthesia Care Unit (PACU)

The time from arriving at the postanesthesia care unit (PACU) until the time the patient is considered ready for discharge (in minutes). (NCT02726620)
Timeframe: A specific time frame on the day of surgery: from the start of admission to the PACU to discharge from the PACU, an expected average of 4 hours

Interventionminutes (Median)
Usual Care Group67
Hypotension Decision Support60

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Timing of Cardiovascular Drugs for MAP < 50 mmHg

Cardiovascular drugs as defined under interventions. Time of first administration of cardiovascular drug relative to the time at which the mean arterial pressure (MAP) drops below 50 mmHg. Per patient the average time to first administration of all hypotensive episodes was calculated. That average time is used as the outcome variable. A negative value indicates that administration occurred before the drop in MAP. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionminutes (Median)
Usual Care Group1
Hypotension Decision Support0

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Timing of Cardiovascular Drugs for MAP < 55 mmHg

Cardiovascular drugs as defined under interventions. Time of first administration of cardiovascular drug relative to the time at which the mean arterial pressure (MAP) drops below 55 mmHg. Per patient the average time to first administration of all hypotensive episodes was calculated. That average time is used as the outcome variable. A negative value indicates that administration occurred before the drop in MAP. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionminutes (Median)
Usual Care Group1
Hypotension Decision Support0.5

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Timing of Cardiovascular Drugs for MAP < 60 mmHg

Cardiovascular drugs as defined under interventions. Time of first administration of cardiovascular drug relative to the time at which the mean arterial pressure (MAP) drops below 60 mmHg. Per patient the average time to first administration of all hypotensive episodes was calculated. That average time is used as the outcome variable. A negative value indicates that administration occurred before the drop in MAP. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionminutes (Median)
Usual Care Group0.8
Hypotension Decision Support1.5

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Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 65 mmHg

Average concentrations of inhalational anesthesia during MAP < 65 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

,
InterventionEndTidal% (other) (Median)
Sevoflurane (EndTidal %)Isoflurane (EndTidal %)Desflurane (EndTidal %)
Hypotension Decision Support1.270.682.31
Usual Care Group1.350.684.10

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Incidence of a MAP < 50 mmHg for > 20 Minutes

Incidence of a mean arterial pressure (MAP) < 50 mmHg for a cumulative duration of all hypotensive episodes of more than 20 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group304
Hypotension Decision Support85

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Incidence of a MAP < 55 mmHg

Incidence of a mean arterial pressure (MAP) < 55 mmHg during anesthesia for 1 minute or more. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group10991
Hypotension Decision Support3045

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Incidence of a MAP < 50 mmHg for > 10 Minutes

Incidence of a mean arterial pressure (MAP) < 50 mmHg for a cumulative duration of all hypotensive episodes of more than 10 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group1159
Hypotension Decision Support326

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Incidence of a MAP < 55 mmHg for > 10 Minutes

Incidence of a mean arterial pressure (MAP) < 55 mmHg for a cumulative duration of all hypotensive episodes of more than 10 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group3181
Hypotension Decision Support759

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Incidence of a MAP < 55 mmHg for > 20 Minutes

Incidence of a mean arterial pressure (MAP) < 55 mmHg for a cumulative duration of all hypotensive episodes of more than 20 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group1223
Hypotension Decision Support284

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Incidence of a MAP < 60 mmHg

Incidence of a mean arterial pressure (MAP) < 60 mmHg during anesthesia for 1 minute or more. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group13779
Hypotension Decision Support3798

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Incidence of a MAP < 60 mmHg for > 10 Minutes

Incidence of a mean arterial pressure (MAP) < 60 mmHg for a cumulative duration of all hypotensive episodes of more than 10 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group6989
Hypotension Decision Support1723

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Incidence of a MAP < 60 mmHg for > 20 Minutes

Incidence of a mean arterial pressure (MAP) < 60 mmHg for a cumulative duration of all hypotensive episodes of more than 20 minutes during the anesthetic phase of the procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group3632
Hypotension Decision Support792

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Intraoperative Administration of Intravenous Fluids

Total amount (mL) of intravenous fluids (as defined under interventions) administered during the surgical procedure. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmL (Median)
Usual Care Group1500.00
Hypotension Decision Support1400.00

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Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 50 mmHg

Average concentrations of propofol infusion rates during MAP < 50 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmcg/kg/min (propofol) (Median)
Usual Care Group65.00
Hypotension Decision Support50.00

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Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 55 mmHg

Average concentrations of propofol infusion rates during MAP < 55 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmcg/kg/min (propofol) (Median)
Usual Care Group63.95
Hypotension Decision Support50.00

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Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 60 mmHg

Average concentrations of propofol infusion rates during MAP < 60 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmcg/kg/min (propofol) (Median)
Usual Care Group61.07
Hypotension Decision Support50.00

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Intravenous Anesthetic Drug Use During Intraoperative Hypotension: MAP < 65 mmHg

Average concentrations of propofol infusion rates during MAP < 65 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmcg/kg/min (propofol) (Median)
Usual Care Group60.10
Hypotension Decision Support48.59

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Depth and Duration of Intraoperative Hypotension - Threshold MAP 55 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group23
Hypotension Decision Support23

[back to top]

Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 60 mmHg

Average concentrations of inhalational anesthesia during MAP < 60 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

,
InterventionEndTidal% (other) (Median)
Sevoflurane (EndTidal %)Isoflurane (EndTidal %)Desflurane (EndTidal %)
Hypotension Decision Support1.250.672.33
Usual Care Group1.350.684.36

[back to top]

Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 55 mmHg

Average concentrations of inhalational anesthesia during MAP < 55 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

,
InterventionEndTidal% (other) (Median)
Sevoflurane (EndTidal %)Isoflurane (EndTidal %)Desflurane (EndTidal %)
Hypotension Decision Support1.250.674.65
Usual Care Group1.340.684.60

[back to top]

Incidence of a MAP < 50 mmHg

Incidence of a mean arterial pressure (MAP) < 50 mmHg during anesthesia for 1 minute or more. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group7781
Hypotension Decision Support2196

[back to top]

In-hospital Mortality

Hospital mortality rate during a single hospital admission after the surgery (NCT02726620)
Timeframe: All postoperative days during a single hospital admission, expected median of 5 days

InterventionParticipants (Count of Participants)
Usual Care Group487
Hypotension Decision Support137

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Estimated Intraoperative Blood Loss

The estimated blood loss in mL during the surgical procedure (NCT02726620)
Timeframe: During the surgical procedure: an expected average of 2 hours

InterventionmL (Median)
Usual Care Group100
Hypotension Decision Support75

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Depth and Duration of Intraoperative Hypotension - Threshold MAP 70 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group273
Hypotension Decision Support235

[back to top]

Depth and Duration of Intraoperative Hypotension - Threshold MAP 65 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group96
Hypotension Decision Support86

[back to top]

Depth and Duration of Intraoperative Hypotension - Threshold MAP 60 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group57
Hypotension Decision Support52

[back to top]

Depth and Duration of Intraoperative Hypotension - Threshold MAP 50 mmHg

Depth and duration of intraoperative hypotension will be modeled by calculating areas under the threshold for mean arterial pressures (MAPs). Thresholds will vary from 75 mmHg to 50 mmHg in 5 mmHg decrements. Together these variables represent the depth and duration of intraoperative hypotension. To optimize goodness of fit of these variables, the decremental steps may be increased to 10 mmHg and more restrictive lowest and highest thresholds may be chosen for the statistical analysis. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionmmHg*minute (Median)
Usual Care Group19
Hypotension Decision Support19

[back to top]

Average Use of Cardiovascular Drugs: Phenylephrine

Cardiovascular drugs as defined under interventions. Average use for each drug will be calculated. Cardiovascular drugs that were given in <1% of cases are not reported, as the average dosage would be meaningless. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmg (Median)
Usual Care Group0.90
Hypotension Decision Support1.30

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Average Use of Cardiovascular Drugs: Norepinephrine

Cardiovascular drugs as defined under interventions. Average use for each drug will be calculated. Cardiovascular drugs that were given in <1% of cases are not reported, as the average dosage would be meaningless. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmg (Median)
Usual Care Group0.62
Hypotension Decision Support0.70

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Average Use of Cardiovascular Drugs: Glycopyrrolate

Cardiovascular drugs as defined under interventions. Average use for each drug will be calculated. Cardiovascular drugs that were given in <1% of cases are not reported, as the average dosage would be meaningless. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmg (Median)
Usual Care Group0.40
Hypotension Decision Support0.40

[back to top]

Average Use of Cardiovascular Drugs: Epinephrine

Cardiovascular drugs as defined under interventions. Average use for each drug will be calculated. Cardiovascular drugs that were given in <1% of cases are not reported, as the average dosage would be meaningless. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmg (Median)
Usual Care Group1.00
Hypotension Decision Support0.70

[back to top]

Average Use of Cardiovascular Drugs: Ephedrine

Cardiovascular drugs as defined under interventions. Average use for each drug will be calculated. Cardiovascular drugs that were given in <1% of cases are not reported, as the average dosages would be meaningless. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

Interventionmg (Median)
Usual Care Group20
Hypotension Decision Support15

[back to top]

30-day Mortality

Vanderbilt University Medical Center: combination of in-hospital mortality and 'alive-index' (which checks for visits to the hospital in the electronic healthcare record as indication of being alive at 30 days) (NCT02726620)
Timeframe: 30 days after surgery

InterventionParticipants (Count of Participants)
Usual Care Group511
Hypotension Decision Support143

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Inhaled Anesthetic Drug Use During Intraoperative Hypotension: MAP < 50 mmHg

Average concentrations of inhalational anesthesia during MAP < 50 mmHg episodes (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

,
InterventionEndTidal% (other) (Median)
Sevoflurane (EndTidal %)Isoflurane (EndTidal %)Desflurane (EndTidal %)
Hypotension Decision Support1.230.654.70
Usual Care Group1.320.654.28

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Usage Frequency of Cardiovascular Drugs: Phenylephrine

Cardiovascular drugs as defined under interventions. Frequency of patients receiving the drug. Cardiovascular drugs that were given in <1% of cases are not reported. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group12211
Hypotension Decision Support3685

[back to top]

Usage Frequency of Cardiovascular Drugs: Norepinephrine

Cardiovascular drugs as defined under interventions. Frequency of patients receiving the drug. Cardiovascular drugs that were given in <1% of cases are not reported. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group762
Hypotension Decision Support233

[back to top]

Usage Frequency of Cardiovascular Drugs: Glycopyrrolate

Cardiovascular drugs as defined under interventions. Frequency of patients receiving the drug. Cardiovascular drugs that were given in <1% of cases are not reported. (NCT02726620)
Timeframe: During the anesthetic phase of the surgical procedure: an expected average of 2.5 hours

InterventionParticipants (Count of Participants)
Usual Care Group11093
Hypotension Decision Support1257

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Operating Room (OR) Turnover Time When Using Sugammadex Instead of Combination of Neostigmine and Glycopyrrolate.

(NCT02860507)
Timeframe: through start of next surgery, average of 2 hours

InterventionMinutes (Mean)
Neostigmine + Glycopyrrolate49.7
Sugammadex49.45

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Number of Patients Who Experience Postoperative Nausea and Vomiting, Post-operative Pain, and Post-operative Complications

(NCT02860507)
Timeframe: through discharge from hospital, average of 72 hours

InterventionParticipants (Count of Participants)
Neostigmine + Glycopyrrolate8
Sugammadex10

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Treatment Failure Defined by Increase in Lower Respiratory Symptoms Necessitating Treatment With Active, Long-acting Inhaled Bronchodilator, Corticosteroids or Antibiotics

Treatment failure defined by increase in lower respiratory symptoms necessitating treatment with active, long-acting inhaled bronchodilator, corticosteroids or antibiotics (NCT02867761)
Timeframe: During study follow-up (baseline to 12 Weeks)

InterventionParticipants (Count of Participants)
Indacaterol/Glycopyrrolate5
Placebo9

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Proportion of Individuals With Both a 4 Unit Improvement in SGRQ and a 1 Unit Improvement in BDI/TDI Without Treatment Failure

Measured by units of improvement in SGRQ scores at Baseline and 12 weeks, as well as review of treatment failure status at 4 weeks and 12 weeks of treatment (treatment failure is defined by an increase in lower respiratory symptoms necessitating treatment with active, long-acting inhaled bronchodilator, corticosteroids or antibiotics). (NCT02867761)
Timeframe: 12 weeks

InterventionParticipants (Count of Participants)
Indacaterol/Glycopyrrolate55
Placebo60

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Proportion of Individuals With a 2 Unit Improvement in CAT Without Treatment Failure

Proportion of individuals with a 2 unit improvement in CAT without treatment failure (NCT02867761)
Timeframe: 12 weeks

InterventionParticipants (Count of Participants)
Indacaterol/Glycopyrrolate169
Placebo166

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Proportion of Individuals With a 1 Unit Improvement in the BDI/TDI Without Treatment Failure

Proportion of individuals with a 1 unit improvement in the BDI/TDI without treatment failure (NCT02867761)
Timeframe: 12 weeks

InterventionParticipants (Count of Participants)
Indacaterol/Glycopyrrolate80
Placebo80

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Proportion (Percentage) of Individuals Who Experience a 4 Unit Improvement in St. George's Respiratory Questionnaire (SGRQ) at 12 Weeks and do Not Meet Criteria for Treatment Failure During the 12 Week Treatment Period

"Measured by units of improvement in SGRQ scores at Baseline and 12 weeks, as well as review of treatment failure status at 4 weeks and 12 weeks of treatment (treatment failure is defined by an increase in lower respiratory symptoms necessitating treatment with active, long-acting inhaled bronchodilator, corticosteroids or antibiotics).~A 4 unit change is the minimum clinically important difference. SGRQ has a 0 - 100 score; 0 as low symptoms (feeling better) and 100 as high symptoms (feeling worse)." (NCT02867761)
Timeframe: Baseline and 12 weeks

InterventionParticipants (Count of Participants)
Indacaterol/Glycopyrrolate128
Placebo144

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Mean Change in COPD Assessment Test (CAT)

Value at 12 Weeks Minus Baseline. 0 - 40; 0 as low symptoms (feeling better) and 40 as high symptoms (feeling worse). (NCT02867761)
Timeframe: Baseline, 12 weeks

Interventionscore on a scale (Mean)
Indacaterol/Glycopyrrolate-4.5
Placebo-4.8

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Mean Change in St. George's Respiratory Questionnaire (SGRQ)

Value at 12 Weeks Minus Baseline. SGRQ has a 0 - 100 score; 0 as low symptoms (feeling better) and 100 as high symptoms (feeling worse). (NCT02867761)
Timeframe: Baseline, 12 weeks

Interventionscore on a scale (Mean)
Indacaterol/Glycopyrrolate-7.7
Placebo-8.9

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Symptoms and Rescue Medication Use Based on Daily Diary

Percentage of days with symptoms (shortness of breath, chest tightness, wheezing, cough, or sputum) or use of albuterol (NCT02867761)
Timeframe: During study follow-up (Baseline to 12 weeks)

Interventionpercentage of days (Mean)
Indacaterol/Glycopyrrolate67.0
Placebo63.6

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Area Under the Curve (AUC) 0-3 Hours for FEV1

FEV1 AUC0-3h was calculated as the area under the FEV1-time curve from 0 to 3h post-dose using the trapezoidal rule, divided by the duration (3h) to report in liters. (NCT02867761)
Timeframe: At 12 weeks, FEV1 is measured at 1-hour intervals for 3 hours

Interventionliters (Mean)
Indacaterol/Glycopyrrolate8.09
Placebo7.82

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Change in FEF25-75%

FEF25-75%-Forced expiratory flow over the middle one half of the FVC; the average flow from the point at which 25 percent of the FVC has been exhaled to the point at which 75 percent of the FVC has been exhaled. (NCT02867761)
Timeframe: Baseline to 12 weeks

InterventionLiters per second (Mean)
Indacaterol/Glycopyrrolate0.07
Placebo-0.08

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Change From Baseline in 12 Hour Trough Inspiratory Capacity - Absolute Value

Change from baseline in 12 hour trough inspiratory capacity - absolute value (NCT02867761)
Timeframe: Baseline

InterventionLiters (Least Squares Mean)
Indacaterol/Glycopyrrolate0.12
Placebo0.02

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Change From Baseline in Trough FEV1 - % Predicted

Trough FEV1 at 12 week minus trough FEV1 at baseline. (NCT02867761)
Timeframe: Baseline to 12 Weeks

Interventionpercentage of predicted number (Least Squares Mean)
Indacaterol/Glycopyrrolate2.48
Placebo-0.09

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Change From Baseline in Trough Forced Expiratory Volume Per 1 Second (FEV1) - Absolute Value

Trough FEV1 at 12 week minus trough FEV1 at baseline. (NCT02867761)
Timeframe: Baseline to 12 Weeks

InterventionLiters (Least Squares Mean)
Indacaterol/Glycopyrrolate0.04
Placebo-0.01

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Mean Change in Baseline Dyspnea Index (BDI)/Transition Dyspnea Index (TDI)

Value at 12 Weeks Minus Baseline. (NCT02867761)
Timeframe: 12 Weeks

Interventionratio (Mean)
Indacaterol/Glycopyrrolate0.93
Placebo0.92

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Number of Participants Who Reported Nausea

Did the subject report nausea? The subject will respond with yes or no. (NCT02872935)
Timeframe: From the administration of the spinal anesthesia to delivery of baby - Total time 90minutes

InterventionParticipants (Count of Participants)
Placebo: Normal Saline8
Glycopyrrolate Group7

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Number of Participants Who Experienced Vomiting.

This measure is observed by care team. Reported as vomiting, yes or no. (NCT02872935)
Timeframe: From the administration of the spinal anesthesia to delivery of baby; Total time 90minutes

InterventionParticipants (Count of Participants)
Placebo: Normal Saline4
Glycopyrrolate Group2

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Number of Subjects With Clinically Significant ECG Parameters Reported During the Study

ECGs were recorded at screening and at each study treatment visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment. (NCT02948582)
Timeframe: 0 to 24h

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution12.5μg0
Glycopyrrolate Inhalation Solution 50μg0
Glycopyrrolate Inhalation Solution 100μg0
Glycopyrrolate Inhalation Solution 200μg0
Glycopyrrolate Inhalation Solution 400μg0
Placebo 0.5mL0

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Percentage of Subjects With Treatment Emergent AEs

AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment (NCT02948582)
Timeframe: Day 69 (includes dosing Day 1, washout Day 12, safety follow up Day 69)

Interventionpercentage of participants (Number)
Glycopyrrolate Inhalation Solution12.5μg41.0
Glycopyrrolate Inhalation Solution 50μg36.8
Glycopyrrolate Inhalation Solution 100μg45.9
Glycopyrrolate Inhalation Solution 200μg40.5
Glycopyrrolate Inhalation Solution 400μg35.1
Placebo 0.5mL37.8

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t1/2; Plasma Half-life

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02948582)
Timeframe: 0 to 12 hour

Interventionhours (Geometric Mean)
Glycopyrrolate Inhalation Solution 50μg0.8949
Glycopyrrolate Inhalation Solution 100μg3.0137
Glycopyrrolate Inhalation Solution 200μg3.1663
Glycopyrrolate Inhalation Solution 400μg4.1238

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Tmax; Time to Maximum Observed Plasma Concentration

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02948582)
Timeframe: 0 to 12 hours

Interventionhours (Median)
Glycopyrrolate Inhalation Solution12.5μg0.165
Glycopyrrolate Inhalation Solution 50μg0.320
Glycopyrrolate Inhalation Solution 100μg0.260
Glycopyrrolate Inhalation Solution 200μg0.275
Glycopyrrolate Inhalation Solution 400μg0.180

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Trough FEV1 (Change From Baseline)

"Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines.~Trough FEV1 was defined as the mean of FEV1 values obtained at 23 hours 30 minutes and 24 hours post-dose of each Treatment Visit." (NCT02948582)
Timeframe: 24hr post dose

Interventionliters (Mean)
Glycopyrrolate Inhalation Solution12.5μg-0.093
Glycopyrrolate Inhalation Solution 50μg0.0114
Glycopyrrolate Inhalation Solution 100μg0.0447
Glycopyrrolate Inhalation Solution 200μg0.0542
Glycopyrrolate Inhalation Solution 400μg0.0292
Placebo 0.5mL-0.0612

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Number of Subjects Who Died, Number of Subjects With Treatment Emergent SAEs, Number of Subjects Who Discontinued Due to AE

AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment (NCT02948582)
Timeframe: Day 69 (includes dosing Day 1, washout Day 12, safety follow up Day 69)

,,,,,
Interventionparticipants (Number)
subjects who diedsubjects with treatment emergent SAEsSubjects whodiscontinued due to an AEsubjects with treatment emergent AEs
Glycopyrrolate Inhalation Solution 100μg01217
Glycopyrrolate Inhalation Solution 200μg00015
Glycopyrrolate Inhalation Solution 400μg00013
Glycopyrrolate Inhalation Solution 50μg00214
Glycopyrrolate Inhalation Solution12.5μg00216
Placebo 0.5mL00014

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Peak FEV1 (Change From Baseline and Percent Change)

spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The peak FEV1 was defined as the highest post-dose FEV1 value within 4 hrs after the dose. Percent change from baseline was calculated as 100 times the difference of peak FEV1 minus baseline FEV1 divided by baseline FEV1. (NCT02948582)
Timeframe: 0-4h post dose

,,,,,
Interventionliters (Mean)
Change from baselinepercent change from baseline
Glycopyrrolate Inhalation Solution 100μg0.26024.14
Glycopyrrolate Inhalation Solution 200μg0.29226.73
Glycopyrrolate Inhalation Solution 400μg0.27225.44
Glycopyrrolate Inhalation Solution 50μg0.22921.05
Glycopyrrolate Inhalation Solution12.5μg0.16515.30
Placebo 0.5mL0.0615.24

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Standardized FEV1 AUC0-24 Area Under the FEV1 Curve From 0 to 24 Hours Post-dose (Actual and Change Baseline)

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The standardized actual FEV1 AUC(0-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-24) was also calculated similarly, using the change from pre-dose FEV1. (NCT02948582)
Timeframe: 0 to 24h

,,,,,
Interventionliters (Mean)
Actual standardized FEV1 AUC0_12change from baseline standardized FEV1 AUC0_12
Glycopyrrolate Inhalation Solution 100μg1.2810.082
Glycopyrrolate Inhalation Solution 200μg1.3130.123
Glycopyrrolate Inhalation Solution 400μg1.3250.105
Glycopyrrolate Inhalation Solution 50μg1.2570.072
Glycopyrrolate Inhalation Solution12.5μg1.2120.009
Placebo 0.5mL1.151-0.053

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AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02948582)
Timeframe: 0 to 12 hour

Interventionpg.h/ml (Geometric Mean)
Glycopyrrolate Inhalation Solution 50μg246.84
Glycopyrrolate Inhalation Solution 100μg634.65
Glycopyrrolate Inhalation Solution 200μg772.59
Glycopyrrolate Inhalation Solution 400μg1367.76

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Standardized FEV1AUC12-24 Area Under the FEV1 Curve From 12 to 24 Hours Post- Dose (Actual and Change From Baseline).

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. The standardized actual FEV1 AUC(12-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(12-24) was also calculated similarly, using the change from pre-dose FEV1. (NCT02948582)
Timeframe: 12-24h post dose

,,,,,
Interventionliters (Mean)
acutal standardized FEV1 AUC0_12change from baseline standardized FEV1 AUC0_12
Glycopyrrolate Inhalation Solution 100μg1.2270.028
Glycopyrrolate Inhalation Solution 200μg1.2530.063
Glycopyrrolate Inhalation Solution 400μg1.2590.039
Glycopyrrolate Inhalation Solution 50μg1.2030.018
Glycopyrrolate Inhalation Solution12.5μg1.165-0.038
Placebo 0.5mL1.123-0.082

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Standardized FEV1AUC0-12 Area Under the FEV1 Curve From 0 to 12 Hours Post-dose ( Actual and Change From Baseline).

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines.. The standardized actual FEV1 AUC(0-12) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-12) was also calculated similarly, using the change from pre-dose FEV1. (NCT02948582)
Timeframe: 0-12h post dose

,,,,,
Interventionliters (Mean)
actual standardized FEV1 AUC0_12change from baseline standardized FEV1 AUC0_12
Glycopyrrolate Inhalation Solution 100μg1.3350.136
Glycopyrrolate Inhalation Solution 200μg1.3740.184
Glycopyrrolate Inhalation Solution 400μg1.3900.170
Glycopyrrolate Inhalation Solution 50μg1.3110.126
Glycopyrrolate Inhalation Solution12.5μg1.2590.055
Placebo 0.5mL1.180-0.024

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Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study

Vital signs were measured at screening and at each Treatment Visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment. (NCT02948582)
Timeframe: 0-24 h

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution12.5μg0
Glycopyrrolate Inhalation Solution 50μg0
Glycopyrrolate Inhalation Solution 100μg0
Glycopyrrolate Inhalation Solution 200μg0
Glycopyrrolate Inhalation Solution 400μg0
Placebo 0.5mL0

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Number of Clinically Significant Abnormal Laboratory Results Reported During the Study

Clinical safety lab parameters were collected at screening and at the post study assessment. Any laboratory values that were out of range of normal reference values were evaluated by the Investigators. (NCT02948582)
Timeframe: Day -14, Day 69

Interventionnumber of events (Number)
Glycopyrrolate Inhalation Solution12.5μg0
Glycopyrrolate Inhalation Solution 50μg0
Glycopyrrolate Inhalation Solution 100μg0
Glycopyrrolate Inhalation Solution 200μg0
Glycopyrrolate Inhalation Solution 400μg0
Placebo 0.5mL0

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Cmax; Maximum Observed Plasma Concentration

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02948582)
Timeframe: 0 to 12 hour

Interventionpg/mL (Geometric Mean)
Glycopyrrolate Inhalation Solution12.5μg59.25
Glycopyrrolate Inhalation Solution 50μg74.48
Glycopyrrolate Inhalation Solution 100μg144.58
Glycopyrrolate Inhalation Solution 200μg316.05
Glycopyrrolate Inhalation Solution 400μg504.93

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AUC0-t; Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Measurable Drug Concentration.

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02948582)
Timeframe: 0 to 12 hour

Interventionpg.h/ml (Geometric Mean)
Glycopyrrolate Inhalation Solution12.5μg135.87
Glycopyrrolate Inhalation Solution 50μg67.18
Glycopyrrolate Inhalation Solution 100μg237.80
Glycopyrrolate Inhalation Solution 200μg677.24
Glycopyrrolate Inhalation Solution 400μg1481.36

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Number of Subjects With Treatment Emergent AEs

AEs are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment. SAEs are AEs that result in the following outcomes: death, are life-threatening, persistent or significant disability/incapacity, congenital anomaly/birth defect, or important medical events that may have been considered a SAE when, based upon appropriate medical judgment, they may have jeopardized the subject and may have required medical or surgical intervention to prevent one of the outcomes listed in the definition. (NCT02951312)
Timeframe: 0-47 days

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg2
Glycopyrrolate Inhalation Solution 75mg2
Glycopyrrolate Inhalation Solution 200mg4
Glycopyrrolate Inhalation Solution 200mg Jet2
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg2
Placebo 0.5 mL1

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Number of Subjects Who Discontinued Due to AE

AEs are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment. (NCT02951312)
Timeframe: 0-47 days

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Number of Subjects With Clinically Significant Abnormal Laboratory Results Reported During the Study

Clinical safety lab parameters were collected at screening and at the post study follow-up assessment. The clinical significance of each out of normal range laboratory parameter was determined by the investigator during the study. (NCT02951312)
Timeframe: day 47 (post studyfollow-up assessment)

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Number of Subjects With Clinically Significant Abnormal Laboratory Results Reported During the Study

Clinical safety lab parameters were collected at screening and at the post study follow-up assessment. The clinical significance of each out of normal range laboratory parameter was determined by the investigator during the study. (NCT02951312)
Timeframe: post study follow-up assessment (Day 47)

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study

Vital signs were measured at screening, during the study (pre-dose, and 30 and 60 minutes and 2, 4, 8, 12, 24 and 30 hours post-dose) and at post study assessment. The clinical significance of each out of normal range vital sign parameter was determined by the investigator during the study. (NCT02951312)
Timeframe: 30 hrs post dose

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Number of Subjects With Clinically Significant ECG Parameters Reported During the Study

ECGs were measured at screening, during the study (pre-dose, and 30 and 60 minutes and 2, 4, 8, 12, 24 and 30 hours post-dose) and at post study follow-up assessment. (NCT02951312)
Timeframe: 30hr post dose

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Number of Subjects Who Died

(NCT02951312)
Timeframe: 0-47 days

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Peak FEV1 (Change From Baseline )

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. (NCT02951312)
Timeframe: 0 to 4hr

Interventionliters (Mean)
Glycopyrrolate Inhalation Solution 25mg0.212
Glycopyrrolate Inhalation Solution 75mg0.255
Glycopyrrolate Inhalation Solution 200mg0.303
Glycopyrrolate Inhalation Solution 200mg Jet0.233
Glycopyrrolate Inhalation Solution 500mg0.177
Glycopyrrolate Inhalation Solution1000mg0.283
Placebo 0.5 mL0.120

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Number of Subjects With Treatment Emergent SAEs

AEs are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment.AEs are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment. SAEs are AEs that result in the following outcomes: death, are life-threatening, persistent or significant disability/incapacity, congenital anomaly/birth defect, or important medical events that may have been considered a SAE when, based upon appropriate medical judgment, they may have jeopardized the subject and may have required medical or surgical intervention to prevent one of the outcomes listed in the definition. (NCT02951312)
Timeframe: 0-47 days

InterventionParticipants (Count of Participants)
Glycopyrrolate Inhalation Solution 25mg0
Glycopyrrolate Inhalation Solution 75mg0
Glycopyrrolate Inhalation Solution 200mg0
Glycopyrrolate Inhalation Solution 200mg Jet0
Glycopyrrolate Inhalation Solution 500mg0
Glycopyrrolate Inhalation Solution1000mg0
Placebo 0.5 mL0

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Peak FEV1 (Percent Change)

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. (NCT02951312)
Timeframe: 0 to 4hr

Interventionpercent change (Mean)
Glycopyrrolate Inhalation Solution 25mg17.12
Glycopyrrolate Inhalation Solution 75mg15.60
Glycopyrrolate Inhalation Solution 200mg22.98
Glycopyrrolate Inhalation Solution 200mg Jet19.28
Glycopyrrolate Inhalation Solution 500mg11.47
Glycopyrrolate Inhalation Solution1000mg16.87
Placebo 0.5 mL6.80

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Percentage of Subjects With Treatment Emergent AEs

AEs are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment. (NCT02951312)
Timeframe: 0-47 days

Interventionpercentage of participants (Number)
Glycopyrrolate Inhalation Solution 25mg33.3
Glycopyrrolate Inhalation Solution 75mg33.3
Glycopyrrolate Inhalation Solution 200mg66.7
Glycopyrrolate Inhalation Solution 200mg Jet33.3
Glycopyrrolate Inhalation Solution 500mg0.0
Glycopyrrolate Inhalation Solution1000mg33.3
Placebo 0.5 mL16.7

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t1/2 Plasma Half-life

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr. (NCT02951312)
Timeframe: 0 to 12 hours post-dose

Interventionhour (Mean)
Glycopyrrolate Inhalation Solution 200mg2.947
Glycopyrrolate Inhalation Solution 200mg Jet0.778
Glycopyrrolate Inhalation Solution 500mg6.298
Glycopyrrolate Inhalation Solution1000mg7.573

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Tmax Time to Maximum Observed Plasma Concentration

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02951312)
Timeframe: 0 to 12 hours post dose

Interventionhours (Mean)
Glycopyrrolate Inhalation Solution 200mg.025
Glycopyrrolate Inhalation Solution 200mg Jet0.08
Glycopyrrolate Inhalation Solution 500mg0.25
Glycopyrrolate Inhalation Solution1000mg0.17

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Trough FEV1 (Change From Baseline)

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. Trough FEV1 was defined as the spirometry value collected at 24 hours post dose within each Treatment Period. (NCT02951312)
Timeframe: 24hr post dose

Interventionliters (Mean)
Glycopyrrolate Inhalation Solution 25mg0.038
Glycopyrrolate Inhalation Solution 75mg0.087
Glycopyrrolate Inhalation Solution 200mg0.138
Glycopyrrolate Inhalation Solution 200mg Jet-0.013
Glycopyrrolate Inhalation Solution 500mg-0.017
Glycopyrrolate Inhalation Solution1000mg0.065
Placebo 0.5 mL-0.030

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FEV1 AUC0-24 Area Under the FEV1 Over Time Curve (Change From Baseline)

Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. (NCT02951312)
Timeframe: 0 to 24hr post dose

Interventionliters (Mean)
Glycopyrrolate Inhalation Solution 25mg1.59
Glycopyrrolate Inhalation Solution 75mg3.10
Glycopyrrolate Inhalation Solution 200mg3.19
Glycopyrrolate Inhalation Solution 200mg Jet1.35
Glycopyrrolate Inhalation Solution 500mg1.53
Glycopyrrolate Inhalation Solution1000mg3.08
Placebo 0.5 mL-0.11

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Cmax Maximum Observed Plasma Concentration

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02951312)
Timeframe: 0 to 12 hours post dose

Interventionpg/mL (Mean)
Glycopyrrolate Inhalation Solution 200mg177.242
Glycopyrrolate Inhalation Solution 200mg Jet75.530
Glycopyrrolate Inhalation Solution 500mg749.872
Glycopyrrolate Inhalation Solution1000mg1534.057

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AUC0-t Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02951312)
Timeframe: 0 to 12 hourr post dose

Interventionpg*h/mL (Mean)
Glycopyrrolate Inhalation Solution 200mg429.335
Glycopyrrolate Inhalation Solution 200mg Jet26.176
Glycopyrrolate Inhalation Solution 500mg2014.276
Glycopyrrolate Inhalation Solution1000mg4084.763

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AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity

Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr (NCT02951312)
Timeframe: 0 to 12 hours post dose

Interventionpg*h/mL (Mean)
Glycopyrrolate Inhalation Solution 200mg563.416
Glycopyrrolate Inhalation Solution 200mg Jet65.013
Glycopyrrolate Inhalation Solution 500mg2491.803
Glycopyrrolate Inhalation Solution1000mg5271.099

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Numerical Rating Scale (NRS) Pain Scores at 1 Hour Postop

NRS Pain scores at 1 hour after surgery. Rated on a scale of 0 (no pain) to 10 (worst pain imaginable). (NCT02996591)
Timeframe: 1 hour after PACU admission

Interventionunits on a scale (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.0
General Anesthesia With Popliteal and Adductor Canal Blocks.1.8

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Numerical Rating Scale Pain Scores at 2 Hours Postop

Numerical rating scale pain score as reported by the patient at 2 hours post-operatively. Rated on a scale of 0 (no pain) to 10 (worst pain imaginable). (NCT02996591)
Timeframe: 2 hours after PACU admission

Interventionunits on a scale (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks..4
General Anesthesia With Popliteal and Adductor Canal Blocks..9

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Numerical Rating Scale Pain Scores on Postoperative Day (POD) 1

Numerical Rating Scale Pain from 0-10. 0 being no pain at all. 10 being the worst pain imaginable. (NCT02996591)
Timeframe: 24 hours after surgery

Interventionscore on a scale (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.1
General Anesthesia With Popliteal and Adductor Canal Blocks.1

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Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)

Leiden Perioperative Care Patient Satisfaction questionnaire (LPPSq). From 1-5. 1 being not at all. 5 being extremely. (NCT02996591)
Timeframe: Postoperative day 1

,
Interventionscore on a scale (Mean)
PainSore ThroatBack PainVomitingColdHungerThirst
General Anesthesia With Popliteal and Adductor Canal Blocks.1.51.51.2111.72.2
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.1.41.21.111.31.42.3

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Time Until Patient is Ready for Discharge From Post-Anesthesia Care Unit (PACU) to Home.

Modified Aldrete Scoring System and Marshall and Chung Postanesthesia Discharge Scoring System, measured in time until discharge criteria is met (in minutes) (NCT02996591)
Timeframe: Duration of stay in recovery room after surgery

InterventionMinutes (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.81
General Anesthesia With Popliteal and Adductor Canal Blocks.43.5

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Back Pain on POD1

Back pain (yes/no) on POD1 (NCT02996591)
Timeframe: Postoperative day 1

,
InterventionParticipants (Count of Participants)
NoYes
General Anesthesia With Popliteal and Adductor Canal Blocks.143
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.162

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Opioid Consumption

Opioid consumption (mg OME) during inpatient stay (NCT02996591)
Timeframe: Duration of stay in recovery room after surgery (average 2 hours)

Interventionmg OME (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.2.2
General Anesthesia With Popliteal and Adductor Canal Blocks.5

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Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)

Leiden Perioperative Care Patient Satisfaction questionnaire (LPPSq) score. Performed at 1 hour postoperatively. To what degree did patients have the following symptoms. Rated 1-5, 1 being not at all. 5 being extremely. (NCT02996591)
Timeframe: 1 hour after surgery

,
Interventionscore on a scale (Mean)
PainA Sore ThroatBack PainVomitingColdHungerThirst
General Anesthesia With Popliteal and Adductor Canal Blocks.1.61.61.211.31.72.5
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.1.11.21.211.41.92.7

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Cognitive Recovery at 2 Hours Post-operative

Postoperative Quality Recovery Scale Cognitive Domain questionnaire. Asked at 2 hour post-operatively. Either yes (return to pre-operative cognitive function levels) or no (not yet returned to pre-operative function levels) (NCT02996591)
Timeframe: 2 hours after PACU admission

,
InterventionParticipants (Count of Participants)
NoYes
General Anesthesia With Popliteal and Adductor Canal Blocks.413
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.116

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Cognitive Recovery on POD1

Postoperative Quality Recovery Scale Cognitive Domain questionnaire. Asked on postoperative day 1. Either yes (return to pre-operative cognitive function levels) or no (not yet returned to pre-operative function levels) (NCT02996591)
Timeframe: Postoperative day 1

,
InterventionParticipants (Count of Participants)
NoYes
General Anesthesia With Popliteal and Adductor Canal Blocks.215
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.314

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Incidence of Transient Neurologic Symptoms

(NCT02996591)
Timeframe: Postoperative day 1 and if present, monitored until resolution

,
InterventionParticipants (Count of Participants)
NormalTransient Neurological Symptoms
General Anesthesia With Popliteal and Adductor Canal Blocks.180
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.180

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Postoperative Discomfort and Needs (Post-op Pain, Sore Throat, Back Pain, Nausea, Cold, Hunger, Thirst)

Rating the Nausea/Vomiting of patients post-operatively. (NCT02996591)
Timeframe: 2 hours after surgery

,
Interventionscore on a scale (Mean)
PainSore ThroatBack PainVomitingColdHungerThirst
General Anesthesia With Popliteal and Adductor Canal Blocks.1.41.61.211.11.21.8
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.1.21.21.111.11.42.1

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Assessment of Patient Blinding to Group Assignment

Patients will be asked whether they believe they were in the general anesthesia or spinal anesthesia group. These responses are then validated using the Bang Blinding Index, which either confirms or refutes the validity of the blinding. The scale runs from -1 to 1, with a score of 0 indicating complete blinding, -1 indicating opposite guessing of groups, and 1 indicating a complete lack of blinding. (NCT02996591)
Timeframe: Postoperative day 1

InterventionBang blinding index (Number)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks..588
General Anesthesia With Popliteal and Adductor Canal Blocks..722

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Opioid Consumption Through First Postoperative Day. Measured in mg OME

(NCT02996591)
Timeframe: Postoperative day 1

Interventionmg OME (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.8.3
General Anesthesia With Popliteal and Adductor Canal Blocks.11

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Nausea Intensity

Nausea intensity ranked on NRS score following PACU admission to 2 hours after discharge. Scored from 0-10. 0 Being no nausea, 10 being worst nausea imaginable. (NCT02996591)
Timeframe: 2 hours after PACU admission

Interventionscore on a scale (Mean)
Spinal Anesthesia With Popliteal and Adductor Canal Blocks.0
General Anesthesia With Popliteal and Adductor Canal Blocks.0

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Time to Maximum Plasma Concentration (Tmax) - Budesonide

Time to maximum plasma concentration (tmax) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.333
PT010 (BGF MDI) 160/14.4/9.6 µg0.333

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Terminal Elimination Rate Constant (λz) - Glycopyrronium

Terminal elimination rate constant (λz) - Glycopyrronium - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Intervention1/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg0.122
PT010 (BGF MDI) 160/14.4/9.6 µg0.081
PT003 (GFF MDI) 14.4/9.6 µg0.112

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Terminal Elimination Rate Constant (λz) - Formoterol

Terminal elimination rate constant (λz) - Formoterol - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Intervention1/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg0.136
PT010 (BGF MDI) 160/14.4/9.6 µg0.123
PT003 (GFF MDI) 14.4/9.6 µg0.123

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Terminal Elimination Rate Constant (λz) - Budesonide

Terminal elimination rate constant (λz) - Budesonide - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Intervention1/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg0.152
PT010 (BGF MDI) 160/14.4/9.6 µg0.219

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Maximum Plasma Concentration (Cmax) - Glycopyrronium

Maximum plasma concentration (Cmax) of Glycopyrronium Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg11.303
PT010 (BGF MDI) 160/14.4/9.6 µg11.754
PT003 (GFF MDI) 14.4/9.6 µg13.124

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Maximum Plasma Concentration (Cmax) - Glycopyrronium

Maximum plasma concentration (Cmax) of Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg4.884
PT010 (BGF MDI) 160/14.4/9.6 µg5.286
PT003 (GFF MDI) 14.4/9.6 µg5.674

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Maximum Plasma Concentration (Cmax) - Formoterol

Maximum plasma concentration (Cmax) of Formoterol Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg16.125
PT010 (BGF MDI) 160/14.4/9.6 µg16.945
PT003 (GFF MDI) 14.4/9.6 µg17.710

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Maximum Plasma Concentration (Cmax) - Formoterol

Maximum plasma concentration (Cmax) of Formoterol Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg9.651
PT010 (BGF MDI) 160/14.4/9.6 µg9.932
PT003 (GFF MDI) 14.4/9.6 µg10.618

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Maximum Plasma Concentration (Cmax) - Budesonide

Maximum plasma concentration (Cmax) of Budesonide Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg626.435
PT010 (BGF MDI) 160/14.4/9.6 µg315.425

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Maximum Plasma Concentration (Cmax) - Budesonide

Maximum plasma concentration (Cmax) of Budesonide Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionpg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg459.308
PT010 (BGF MDI) 160/14.4/9.6 µg224.298

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Elimination Half-life (t½) - Glycopyrronium

Elimination half-life (t½) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg5.676
PT010 (BGF MDI) 160/14.4/9.6 µg8.539
PT003 (GFF MDI) 14.4/9.6 µg6.194

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Elimination Half-life (t½) - Formoterol

Elimination half-life (t½) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg5.098
PT010 (BGF MDI) 160/14.4/9.6 µg5.657
PT003 (GFF MDI) 14.4/9.6 µg5.628

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Elimination Half-life (t½) - Budesonide

Elimination half-life (t½) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg4.572
PT010 (BGF MDI) 160/14.4/9.6 µg3.168

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Glycopyrronium

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Glycopyrronium Day 8 (NCT03075267)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg69.487
PT010 (BGF MDI) 160/14.4/9.6 µg77.078
PT003 (GFF MDI) 14.4/9.6 µg72.636

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Glycopyrronium

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg29.400
PT010 (BGF MDI) 160/14.4/9.6 µg27.197
PT003 (GFF MDI) 14.4/9.6 µg29.002

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Formoterol

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Formoterol Day 8 (NCT03075267)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg81.936
PT010 (BGF MDI) 160/14.4/9.6 µg85.322
PT003 (GFF MDI) 14.4/9.6 µg83.499

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Formoterol

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg47.843
PT010 (BGF MDI) 160/14.4/9.6 µg46.492
PT003 (GFF MDI) 14.4/9.6 µg53.583

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Budesonide

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Budesonide Day 8 (NCT03075267)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg2509.888
PT010 (BGF MDI) 160/14.4/9.6 µg1249.615

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Area Under the Plasma Concentration-time Curve From 0-12 Hours (AUC 0-12) - Budesonide

Area under the plasma concentration-time curve from 0-12 hours (AUC 0-12) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1747.910
PT010 (BGF MDI) 160/14.4/9.6 µg811.812

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Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Glycopyrronium

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-t) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg17.616
PT010 (BGF MDI) 160/14.4/9.6 µg17.707
PT003 (GFF MDI) 14.4/9.6 µg20.287

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Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Formoterol

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-t) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg48.326
PT010 (BGF MDI) 160/14.4/9.6 µg47.408
PT003 (GFF MDI) 14.4/9.6 µg45.950

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Area Under the Plasma Concentration-time Curve From 0 to the Time of the Last Measurable Plasma Concentration (AUC 0-t) - Budesonide

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-t) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1884.912
PT010 (BGF MDI) 160/14.4/9.6 µg830.012

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Formoterol

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC 0-∞) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg61.617
PT010 (BGF MDI) 160/14.4/9.6 µg73.123
PT003 (GFF MDI) 14.4/9.6 µg70.608

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Budesonide

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC 0-∞) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1936.211
PT010 (BGF MDI) 160/14.4/9.6 µg876.673

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Apparent Volume of Distribution (Vd/F) - Glycopyrronium

Apparent volume of distribution (Vd/F) - Glycopyrronium - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg2172.038
PT010 (BGF MDI) 160/14.4/9.6 µg2123.999
PT003 (GFF MDI) 14.4/9.6 µg1864.314

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Apparent Volume of Distribution (Vd/F) - Formoterol

Apparent volume of distribution (Vd/F) - Formoterol - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1125.215
PT010 (BGF MDI) 160/14.4/9.6 µg1000.172
PT003 (GFF MDI) 14.4/9.6 µg1035.257

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Apparent Volume of Distribution (Vd/F) - Budesonide

Apparent volume of distribution (Vd/F) - Budesonide - Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1090.237
PT010 (BGF MDI) 160/14.4/9.6 µg834.269

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Apparent Total Body Clearance (CL/F) - Glycopyrronium

Apparent total body clearance (CL/F) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg406.038
PT010 (BGF MDI) 160/14.4/9.6 µg436.184
PT003 (GFF MDI) 14.4/9.6 µg330.757

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Apparent Total Body Clearance (CL/F) - Formoterol

Apparent total body clearance (CL/F) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg155.801
PT010 (BGF MDI) 160/14.4/9.6 µg131.286
PT003 (GFF MDI) 14.4/9.6 µg135.962

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Apparent Total Body Clearance (CL/F) - Budesonide

Apparent total body clearance (CL/F) - Budesonide Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionL/h (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg165.271
PT010 (BGF MDI) 160/14.4/9.6 µg182.508

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Accumulation Ratio for Cmax (RAC [Cmax]) - Glycopyrronium

Accumulation ratio for Cmax (RAC [Cmax]) - Glycopyrronium (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose and Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg2.383
PT010 (BGF MDI) 160/14.4/9.6 µg2.319
PT003 (GFF MDI) 14.4/9.6 µg2.412

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Accumulation Ratio for Cmax (RAC [Cmax]) - Formoterol

Accumulation ratio for Cmax (RAC [Cmax]) - Formoterol (NCT03075267)
Timeframe: Day 1 and Day 8

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1.678
PT010 (BGF MDI) 160/14.4/9.6 µg1.706
PT003 (GFF MDI) 14.4/9.6 µg1.668

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Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium

Time to maximum plasma concentration (tmax) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.100
PT010 (BGF MDI) 160/14.4/9.6 µg0.100
PT003 (GFF MDI) 14.4/9.6 µg0.100

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Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Glycopyrronium

Accumulation ratio for AUC 0-12 (RAC [AUC 0-12]) - Glycopyrronium (NCT03075267)
Timeframe: Day 1 and Day 8

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg3.324
PT010 (BGF MDI) 160/14.4/9.6 µg3.030
PT003 (GFF MDI) 14.4/9.6 µg3.189

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Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Formoterol

Accumulation ratio for AUC 0-12 (RAC [AUC 0-12]) - Formoterol (NCT03075267)
Timeframe: Day 1 and Day 8

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1.718
PT010 (BGF MDI) 160/14.4/9.6 µg1.835
PT003 (GFF MDI) 14.4/9.6 µg1.620

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Accumulation Ratio for AUC 0-12 (RAC [AUC 0-12]) - Budesonide

Accumulation ratio for AUC 0-12 (RAC [AUC 0-12]) - Budesonide (NCT03075267)
Timeframe: Day 1 and Day 8

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1.455
PT010 (BGF MDI) 160/14.4/9.6 µg1.539

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC 0-∞) - Glycopyrronium

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC 0-∞) - Glycopyrronium Day 1 (NCT03075267)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg35.465
PT010 (BGF MDI) 160/14.4/9.6 µg33.014
PT003 (GFF MDI) 14.4/9.6 µg43.537

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Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium

Time to maximum plasma concentration (tmax) - Glycopyrronium Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.333
PT010 (BGF MDI) 160/14.4/9.6 µg0.333
PT003 (GFF MDI) 14.4/9.6 µg0.333

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Time to Maximum Plasma Concentration (Tmax) - Formoterol

Time to maximum plasma concentration (tmax) - Formoterol Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.100
PT010 (BGF MDI) 160/14.4/9.6 µg0.100
PT003 (GFF MDI) 14.4/9.6 µg0.100

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Time to Maximum Plasma Concentration (Tmax) - Formoterol

Time to maximum plasma concentration (tmax) - Formoterol Day 1 (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.833
PT010 (BGF MDI) 160/14.4/9.6 µg0.100
PT003 (GFF MDI) 14.4/9.6 µg0.100

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Time to Maximum Plasma Concentration (Tmax) - Budesonide

Time to maximum plasma concentration (tmax) - Budesonide Day 8 (NCT03075267)
Timeframe: Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

Interventionh (Median)
PT010 (BGF MDI) 320/14.4/9.6 µg0.333
PT010 (BGF MDI) 160/14.4/9.6 µg0.333

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Accumulation Ratio for Cmax (RAC [Cmax]) - Budesonide

Accumulation ratio for Cmax (RAC [Cmax]) - Budesonide (NCT03075267)
Timeframe: Day 1 Pre-dose and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose and Day 8 Pre-dose -60, and 2, 6, 20, 40 min, 1, 2, 4, 8, 10, 12 and 24 h post-dose

InterventionRatio (Geometric Mean)
PT010 (BGF MDI) 320/14.4/9.6 µg1.400
PT010 (BGF MDI) 160/14.4/9.6 µg1.406

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Measure Participants' Recovery Time Post-Surgery

Determine whether SUG, as compared to NEO decreases time for patients to be ready for discharge from the PACU post-surgery. (NCT03116997)
Timeframe: 1 day

Interventionhours (Median)
Neuromuscular Blockade Reversed With Neostigmine/Gly3.59
Neuromuscular Blockade Reversed With Sugammadex3.62

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Peak FEV1 During 4 Hours Post-dose After 1 Week of Treatment

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Peak FEV1 following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The peak effect following 1 week of treatment was defined as the maximum FEV1 during the first 4 hour on that day. (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug2.621
NVA237 25 ug2.630
Placebo2.457

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FEV1 AUC (5 Min - 23 h 45 Min) After One Week of Treatment

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day AUC (5 min - 23 h 45 min) (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug2.443
NVA237 25 ug2.450
Placebo2.304

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FEV1 AUC (5 Min-1 h) After One Week of Treatment

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 5min-1h) (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug2.489
NVA237 25 ug2.492
Placebo2.324

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FEV1 AUC (5 Min-4 h) After One Week of Treatment

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 5min-4h) (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug2.522
NVA237 25 ug2.525
Placebo2.346

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Percent Change From Baseline in FEV1/FVC Ratio

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of FEV1/FVC ratio following 1 week of treatment in respective treatment period (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionPercent change (Mean)
NVA237 50 ug0.018
NVA237 25 ug0.016
Placebo0.003

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Trough FEV1 After One Week of Treatment, Point Estimate

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared to placebo in terms of trough FEV1 (mean of 23h 15 min and 23 h 45 min post -dose) following 1 week of treatment in the respective treatment period. Trough FEV1 was assessed by performing spirometry measurements in the clinic for each treatment period. For the primary efficacy variable, trough FEV1 is the mean of two measurements taken at 23h 15 min and 23h 45 min post dose. (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug2.392
NVA237 25 ug2.392
Placebo2.303

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Mean Morning Peak Expiratory Flow (PEF) Following the 1-week Treatment Period

A Peak Expiratory Flow (PEF) meter was distributed to patients at Visit 1, to be used to measure PEF twice-daily as directed. During the Screening and Treatment Periods, PEF was measured in the morning and evening every day. the morning PEF was performed within 15 minutes after waking, and the evening PEF approximately 12 hours later. Patients were encouraged to perform morning and evening PEF measurements before the use of any LABA or rescue medication. The highest of 3 values was recorded as the daily personal best. The personal best was used to calculate the mean morning PEF and mean evening PEF value (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionL/min (Least Squares Mean)
NVA237 50 ug395.09
NVA237 25 ug393.87
Placebo369.58

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Mean Evening Peak Expiratory Flow Rate (PEF) Following 1-week Treatment

A Peak Expiratory Flow (PEF) meter was distributed to patients at Visit 1, to be used to measure PEF twice-daily as directed. During the Screening and Treatment Periods, PEF was measured in the morning and evening every day. the morning PEF was performed within 15 minutes after waking, and the evening PEF approximately 12 hours later. Patients were encouraged to perform morning and evening PEF measurements before the use of any LABA or rescue medication. The highest of 3 values was recorded as the daily personal best. The personal best was used to calculate the mean morning PEF and mean evening PEF value collected between assessment Visits. LS Mean of change from baseline in mean morning PEF is calculated with the ANCOVA model using treatment, stratification group, dosing schedule, gender, center grouping, smoking status, and baseline mean morning PEF as covariates (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionL/min (Least Squares Mean)
NVA237 50 ug409.66
NVA237 25 ug408.08
Placebo378.72

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Trough Forced Vital Capacity (FVC) After 1 Week of Treatment

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of FVC following 1 week of treatment in respective treatment period. Trough Forced Vital Capacity (FVC) following 7 Days. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionLiters (Least Squares Mean)
NVA237 50 ug3.509
NVA237 25 ug3.530
Placebo3.472

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Mean Daily Number of Puffs of Rescue Medication During 1 Week of Treatment

A day with no rescue medication use is defined from the diary data as any day where the patient recorded no rescue medicine use during the previous 12 hours. daytime and nighttime (combined) number of puffs is defined as the average of the respective number of puffs. (NCT03137784)
Timeframe: Following 1 week of treatment

InterventionPuffs/day (Least Squares Mean)
NVA237 50 ug0.98
NVA237 25 ug1.02
Placebo1.13

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Overall Recovery Time

To determine if Sugammadex can improve overall recovery time, measured by time from end of surgery to the time patient met Discharge Criteria. (NCT03138967)
Timeframe: Up to 3 hours after end of surgery

Interventionhours (Mean)
Suggamadex or Treatment Group2.0847
Neostigime/Glycopyrrolate or Standard of Care Group2.4727

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PostOperative Complications

To determine if Sugammadex can improve post-operative complications for outpatient bladder procedures such as bladder perforation, nausea, vomiting, post-operative intubation and hospital admittance secondary to respiratory complications which was assessed uring follow ups on post-operative day 1 (POD1) and post-operative day 7 (POD7) looking for immediate postoperative complications such as bladder perforation, nausea, vomiting, postoperative intubation and hospital admittance secondary to respiratory complications and readmission within a week post-procedure for any other cause. (NCT03138967)
Timeframe: Post-operatively, up to 7 days

InterventionParticipants (Count of Participants)
Suggamadex or Treatment Group5
Neostigime/Glycopyrrolate or Standard of Care Group7

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Muscle Recovery Time

The primary outcome is to determine if Sugammadex can improve muscle recovery time, measured by time from administration of neuromuscular blockade reversal to train-of-four ratio of 0.9 in outpatient bladder procedures. It was assessed in the intraoperative period measuring the time from administration of reversal agent to TOF of 0.9 in minutes. (NCT03138967)
Timeframe: Intraoperatively, up to 3 hours

Interventionminutes (Mean)
Suggamadex or Treatment Group2
Neostigime/Glycopyrrolate or Standard of Care Group9.24

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Mean Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks in FAS Population

To assess the effects of GFF relative to UV on lung function in FAS population as measured by peak change from baseline in FEV1 is defined as the maximum of the FEV1 assessments within the 2 hours post-dosing time windows at each visit minus baseline using spirometry. Baseline is defined as the mean of the non-missing -60 and -30 minute values obtained prior to dosing at randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day 1) up to 24 weeks

InterventionmL (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate299.1
Umeclidinium/Vilanterol300.8

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Mean Peak Change From Baseline in FEV1 Within 2 Hours Post-dosing Over 24 Weeks in PP Analysis Set Population

To assess the effects of GFF relative to UV on lung function in PP analysis set population as measured by peak change from baseline in FEV1 is defined as the maximum of the FEV1 assessments within the 2 hours post-dosing time windows at each visit minus baseline using spirometry. Baseline is defined as the mean of the non-missing -60 and -30 minute values obtained prior to dosing at randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day 1) up to 24 weeks

InterventionmL (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate293.5
Umeclidinium/Vilanterol296.9

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Mean Peak Change From Baseline in Inspiratory Capacity (IC) Within 2 Hours Post-dosing Over 24 Weeks

Peak change from baseline in IC is defined as the maximum of the IC assessments within the 2 hours post-dosing time windows at each visit minus baseline. Baseline is defined as the average of available evaluable -60 and -30 minute pre-dose assessments conducted at randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day 1) up to 24 weeks

InterventionmL (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate363.1
Umeclidinium/Vilanterol378.3

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Mean Transition Dyspnea Index (TDI) Focal Score Over 24 Weeks

The baseline dyspnea index (BDI) and TDI consist of 3 individual components: functional impairment, magnitude of task, and magnitude of effort. For the BDI, each of these 3 components were rated in 5 grades from 0 (very severe) to 4 (no impairment), and were summed to form a baseline total score from 0 to 12. For the TDI, changes in dyspnea were rated for each component by 7 grades from -3 (major deterioration) to +3 (major improvement), and were added to form a TDI focal score from -9 to +9. Baseline is defined as the latest BDI assessment within 7 days before or at randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day -7 or 1) up to 24 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate1.23
Umeclidinium/Vilanterol1.60

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Percentage of Participants With Increase of FEV1 of >=100 mL From Baseline at 5 Minutes Post-dosing on Day 1

The percentage of participants with an increase in FEV1 of >=100 mL from baseline at 5 minutes post-dosing on Day 1 was determined to assess the early onset of action. Baseline is defined as the average of available evaluable -60 and -30 minute pre-dose assessments conducted at randomization (Day 1). Only data assigned to the 5 minute window was used to determine response. Participants with missing data were considered non-responders for the analysis. (NCT03162055)
Timeframe: 5 minutes post-dose on Day 1

InterventionPercentage of participants (Number)
Glycopyrronium/Formoterol Fumarate60.1
Umeclidinium/Vilanterol40.8

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Mean Change From Baseline in COPD Assessment Test (CAT) Score Over 24 Weeks

The CAT is used to quantify the impact of COPD symptoms on health status. The CAT has a scoring range of 0-40, and it is calculated as the sum of the responses given for each of the 8 items (scored on a 6-point scale from 0 to 5), with higher scores indicating a higher impact of COPD symptoms on health status. If the response to 1 of the 8 items is missing, the missing item was considered equal to the average of the 7 non-missing items for that participant. If more than 1 item is missing the score was considered missing. Baseline is defined as the latest assessment within 7 days before or at randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day -7 or 1) up to 24 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate-2.97
Umeclidinium/Vilanterol-3.56

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Mean Change From Baseline in Daily Rescue (Albuterol/Salbutamol MDI) Use Over 24 Weeks

The number of inhalations of rescue albuterol/salbutamol MDI was recorded in the participant ePRO in the morning and evening. Baseline is defined as the average of the non-missing values from the ePRO data collected in the last 7 days before the randomization (Day 1). a/s = albuterol/salbutamol. (NCT03162055)
Timeframe: From Baseline (Day -7) up to 24 weeks

Interventionpuffs/day (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate-1.70
Umeclidinium/Vilanterol-2.35

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Mean Change From Baseline in Early Morning Symptoms of COPD Instrument (EMSCI) Over 24 Weeks

Change from baseline in the 6-item EMSCI Symptom Severity Score was derived by averaging the responses from a participant on the 6 item-level symptom scores (scored on a 4-point scale from 1 to 4, whereas 1= mild and 4= very severe). The EMSCI collected data about the frequency and severity of early morning symptoms and the impact of COPD symptoms on early morning activity in participants with COPD. Participants completed a daily electronic patient-reported outcome (ePRO) questionnaire for their COPD symptoms. Baseline is defined as the average of the non-missing values from the ePRO data collected in the last 7 days before the randomization (Day 1). TI = Time interval. (NCT03162055)
Timeframe: From Baseline (Day -7) up to 24 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate-0.142
Umeclidinium/Vilanterol-0.176

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Mean Change From Baseline in Morning Pre-dose Trough Forced Expiratory Volume in 1 Second (FEV1) Over 24 Weeks

To assess the effects of GFF relative to UV on lung function as measured by change from baseline in morning pre-dose trough FEV1 is defined as the average of the -60 and -30 minute pre-dose values at each visit minus baseline using spirometry. Baseline is defined as the mean of the non-missing -60 and -30 minute values obtained prior to dosing at randomization (Day 1). BR a/s = bronchodilator responsiveness to albuterol/salbutamol. (NCT03162055)
Timeframe: From Baseline (Day 1) up to 24 weeks

Interventionmilliliter (mL) (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate82.4
Umeclidinium/Vilanterol169.6

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Mean Change From Baseline in Night-Time Symptoms of COPD Instrument (NiSCI) Over 24 Weeks

Change from baseline in the 6-item NiSCI Symptom Severity Score was derived by averaging the responses from a participant on the 6 item-level symptom scores (scored on a 4-point scale from 1 to 4, whereas 1= mild and 4= very severe). The NiSCI collected data about the frequency and severity of night-time symptoms and the impact of COPD symptoms on night-time awakenings in participants with COPD. Participants completed a daily ePRO questionnaire for their COPD symptoms. Baseline is defined as the average of the non-missing values from the ePRO data collected in the last 7 days before the randomization (Day 1). (NCT03162055)
Timeframe: From Baseline (Day -7) up to 24 weeks

InterventionUnits on a scale (Least Squares Mean)
Glycopyrronium/Formoterol Fumarate-0.165
Umeclidinium/Vilanterol-0.207

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Number of Hypoxic Episodes

Hypoxia was defined as an episode of peripheral oxygen saturation (SpO2) <94% on ≤2 L/min of oxygen by nasal cannula, or a SpO2 <98% on ≥2 L/min of oxygen, or postoperative SpO2 of ≥5% reduction compared to preoperative values. (NCT03168308)
Timeframe: Through patient's stay in the early postoperative period, approximately 1-2 hours.

Interventionepisode(s) (Median)
Neostigmine & Glycopyrrolate1
Sugammadex0

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Number of Participants Who Needed Rescue Sugammadex After Initial Reversal of Neuromuscular Blockade

To determine if reversal with sugammadex versus neostigmine requires an additional dose of sugammadex rescue after initial reversal of neuromuscular blockade. (NCT03168308)
Timeframe: From time of reversal to 80 minutes after arrival in the post-anesthesia care unit, approximately 1-2 hours.

InterventionParticipants (Count of Participants)
Neostigmine & Glycopyrrolate5
Sugammadex0

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Time to Complete Reversal of Neuromuscular Blockade

The time from the administration of the blinded reversal syringe until complete reversal of neuromuscular blockade (train of four ratio ≥0.9). (NCT03168308)
Timeframe: From time of reversal to complete reversal of neuromuscular blockade (train of four ratio ≥0.9), approximately 1 hour

Interventionminutes (Mean)
Neostigmine & Glycopyrrolate40
Sugammadex10

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Time to Regular Breathing

time from administration of reversal agent to time of deep, regular breathing (NCT03229486)
Timeframe: time from administration of reversal agent to time of deep, regular breathing, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex273.8
Neostigmine345.1

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Pediatric Anesthesia Emergence Delirium Score

Maximum Pediatric Anesthesia Emergence Delirium (PAED) score after arrival in the PACU.Higher values represent more emergence delirium (worse) PAED Score is represented with total PAED score summed up of subscales. The total score is reported and it ranges from 0 to 20. Higher score means worse state. (NCT03229486)
Timeframe: within 30 minutes after arrival at post-anesthesia care unit (PACU)

Interventionunits on a scale (Median)
Sugammadex18
Neostigmine18

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Time Recovery of TOF Ratio to 0.7

Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.7 (NCT03229486)
Timeframe: Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.7, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex72.7
Neostigmine167.4

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Time Recovery of TOF Ratio to 0.8

Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.8 (NCT03229486)
Timeframe: Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.8, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex83.9
Neostigmine213.6

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Time Recovery of TOF Ratio to 0.9

Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.9 (NCT03229486)
Timeframe: Time from the start of administration of reversal agents to recovery of the TOF ratio to 0.9, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex99.6
Neostigmine253.1

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Time to Awakening

time from administration of reversal agent to time of eye opening or child showing purposeful movement (NCT03229486)
Timeframe: time from administration of reversal agent to time of eye opening or child showing purposeful movements, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex275.8
Neostigmine371.2

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Time to Extubation

time from administration of reversal agent to time of tracheal extubation (NCT03229486)
Timeframe: time from administration of reversal agent to time of tracheal extubation, assessed up to 60 minutes

Interventionseconds (Mean)
Sugammadex312.1
Neostigmine427.3

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Time to Maximum Plasma Concentration (Tmax) - Glycopyrronium

Time to maximum plasma concentration (tmax) - Glycopyrronium (NCT03250182)
Timeframe: Day 1 (pre-dose 2,6,20,40 minutes, 1,2,4,8,10,12,18,24 hours post-dose), Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose)

Interventionhours (Median)
Day 1Day 8
PT0100.030.10

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Time to Maximum Plasma Concentration (Tmax) - Formoterol

Time to maximum plasma concentration (tmax) - Formoterol (NCT03250182)
Timeframe: Day 1 (pre-dose 2,6,20,40 minutes, 1,2,4,8,10,12,18,24 hours post-dose), Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose)

Interventionhours (Median)
Day 1Day 8
PT0100.330.67

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Budesonide

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Budesonide (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT0102407.3

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Time to Maximum Plasma Concentration (Tmax) - Budesonide

Time to maximum plasma concentration (tmax) - Budesonide (NCT03250182)
Timeframe: Day 1 (pre-dose 2,6,20,40 minutes, 1,2,4,8,10,12,18,24 hours post-dose), Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose)

Interventionhours (Median)
Day 1Day 8
PT0100.330.67

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Maximum Plasma Concentration (Cmax) - Glycopyrronium

Maximum plasma concentration (Cmax) - Glycopyrronium (NCT03250182)
Timeframe: Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose)

Interventionpg/mL (Geometric Mean)
PT01018.3

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Maximum Plasma Concentration (Cmax) - Glycopyrronium

Maximum plasma concentration (Cmax) - Glycopyrronium (NCT03250182)
Timeframe: Day 1 (pre-dose 2,6,20,40 minutes, 1,2,4,8,10,12,18,24 hours post-dose)

Interventionpg/mL (Geometric Mean)
PT01017.2

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Maximum Plasma Concentration (Cmax) - Formoterol

Maximum plasma concentration (Cmax) - Formoterol (NCT03250182)
Timeframe: Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose)

Interventionpg/mL (Geometric Mean)
PT0107.4

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Maximum Plasma Concentration (Cmax) - Formoterol

Maximum plasma concentration (Cmax) - Formoterol (NCT03250182)
Timeframe: Day 1 (pre-dose 2,6,20,40 minutes, 1,2,4,8,10,12,18,24 hours post-dose)

Interventionpg/mL (Geometric Mean)
PT0106.4

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Maximum Plasma Concentration (Cmax) - Budesonide

Maximum plasma concentration (Cmax) - Budesonide (NCT03250182)
Timeframe: Day 8 (pre-dose and 2,6,20,40 minutes, 1,2,4,8,10,12 hours post-dose

Interventionpg/mL (Geometric Mean)
PT010663.2

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Maximum Plasma Concentration (Cmax) - Budesonide

Maximum plasma concentration (Cmax) - Budesonide (NCT03250182)
Timeframe: Day 1

Interventionpg/mL (Geometric Mean)
PT010709.3

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Glycopyrronium

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC0-∞) - Glycopyrronium (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01061.2

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Budesonide

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Budesonide (NCT03250182)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT0103004.7

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Formoterol

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC0-∞) - Formoterol (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01046.0

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Area Under the Plasma Concentration-time Curve From 0 Extrapolated to Infinity (AUC0-∞) - Budesonide

Area under the plasma concentration-time curve from 0 extrapolated to infinity (AUC0-∞) - Budesonide (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT0102996.9

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Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Glycopyrronium

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-tlast) - Glycopyrronium (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01039.4

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Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Formoterol

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-tlast) - Formoterol (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01033.4

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Area Under the Plasma Concentration-time Curve (AUC 0-tlast) - Budesonide

Area under the plasma concentration-time curve from 0 to the time of the last measurable plasma concentration (AUC 0-tlast) - Budesonide (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT0102731.8

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Glycopyrronium

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Glycopyrronium (NCT03250182)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT01073.9

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Glycopyrronium

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Glycopyrronium (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01042.5

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Formoterol

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Formoterol (NCT03250182)
Timeframe: Day 8

Interventionh*pg/mL (Geometric Mean)
PT01047.4

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Area Under the Plasma Concentration-time Curve (AUC 0-12) - Formoterol

Area under the plasma concentration-time curve from 0 to 12 hours (AUC 0-12) - Formoterol (NCT03250182)
Timeframe: Day 1

Interventionh*pg/mL (Geometric Mean)
PT01032.6

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Morning Pre-dose Trough FEV1

Change from Baseline in Morning Pre-dose Trough FEV1 (NCT03256552)
Timeframe: Baseline, Day 8

InterventionLiters (Least Squares Mean)
GP MDI 28.8 µg0.101
GP MDI 14.4 µg0.098
GP MDI 7.2 µg0.077
Placebo MDI-0.031

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Peak Change in FEV1

Peak Change from Baseline in FEV1 (NCT03256552)
Timeframe: Day 1 and Day 8

,,,
InterventionLiters (Least Squares Mean)
Day 1Day 8
GP MDI 14.4 µg0.2120.265
GP MDI 28.8 µg0.2540.260
GP MDI 7.2 µg0.1920.238
Placebo MDI0.1040.082

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FVC AUC0-2

Change from Baseline in FVC AUC0-2 on Day 8 normalized for length of follow-up. FVC was measured at 15 min, 30 min, 1 hour, and 2 hours post dose. (NCT03256552)
Timeframe: Baseline, Day 8

InterventionLiters (Least Squares Mean)
GP MDI 28.8 µg0.273
GP MDI 14.4 µg0.265
GP MDI 7.2 µg0.223
Placebo MDI0.047

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FEV1 AUC0-2

Change from Baseline in FEV1 AUC0-2 normalized for length of follow-up. FEV1 was measured at 15 min, 30 min, 1 hour, and 2 hours post dose. (NCT03256552)
Timeframe: Day 1 and Day 8

,,,
InterventionLiters (Least Squares Mean)
Day 1Day 8
GP MDI 14.4 µg0.1400.199
GP MDI 28.8 µg0.1760.194
GP MDI 7.2 µg0.1270.170
Placebo MDI0.0430.019

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Change of Diaphragmatic Contractility Speed- Sniff (Breathing From the Nose), cm/s

The change of diaphragmatic contractility speed was defined as baseline minus postoperative diaphragmatic contraction. (NCT03322657)
Timeframe: from baseline to 90 minutes after the administration of the reversal agent

Interventioncm/s (Mean)
Neostigmine With Glycopyrrolate-0.04
Sugammadex0.29

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Change of Diaphragmatic Contractility Speed, Deep Breathing From Mouth, cm/s

The change of diaphragmatic contractility speed was defined as baseline minus postoperative diaphragmatic contraction. (NCT03322657)
Timeframe: from baseline to 90 minutes after the administration of reversal agent

Interventioncm/s (Mean)
Neostigmine With Glycopyrrolate-0.02
Sugammadex0.80

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TOF Ratio at 90 Min

"TOF (train of four), also known as a peripheral nerve stimulator, is used to assess nerve function in patients receiving neuromuscular blocking agents (paralytic medications). Before giving the medications, the baseline must be measured because this tells how much electrical stimulation the patient needs for nerve stimulation without any paralytic on board.~Our primary outcome TOF ratio between TOF at 90 minutes after the administration of the reversal agent versus the TOF at baseline tells us how well the treatment is working to reverse the rocuronium Neuromuscular. This is a sensitivity analysis of primary analysis." (NCT03322657)
Timeframe: at 90 minutes after the administration of the reversal agent

Interventionratio (Median)
Neostigmine With Glycopyrrolate1.07
Sugammadex1.16

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Time in Minutes to Reach Train of Four (TOF) Ratio ≥ 0.9 After the Administration of Reversal Agent

The primary outcome was a time-to-TOF ratio ≥ 0.9 after the administration of the reversal agent. The TOF ratio was measured in a continuous manner every 12 seconds from the administration of the reversal drug until TOF ratio ≥ 0.9 or until 90 minutes after administration of the reversal agent. (NCT03322657)
Timeframe: within 90 minutes after endotracheal extubation

Interventionminutes (Median)
Neostigmine With Glycopyrrolate8
Sugammadex3

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The Time for Extubation After Administration of Reversal Agents

Time from administration of reversal agent to tracheal extubation (NCT03322657)
Timeframe: Up to 4 hours after administration of reversal agents

Interventionminutes (Median)
Neostigmine With Glycopyrrolate8
Sugammadex8

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Percentage of Participants Experiencing an Event of Clinical Interest (ECI) Up To 7 Days After Administration of Study Intervention

As per the protocol primary analysis, the percentage of participants experiencing an ECI up to 7 days after administration of study intervention was reported. ECIs were a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. A participant could have experienced more than one type of ECI. (NCT03346057)
Timeframe: Up to 7 days

,,,
InterventionPercentage of Participants (Number)
With one or more ECIsAdjudicated HypersensitivityAdjudicated AnaphylaxisClinically Relevant BradycardiaClinically Relevant TachycardiaOther Clinically Relevant Cardiac ArrhythmiaDrug Induced Liver Injury
Neostigmine + Glycopyrrolate3.90.00.02.00.02.00.0
Sugammadex 16 mg/kg7.40.00.00.05.91.50.0
Sugammadex 2 mg/kg1.90.00.00.01.90.00.0
Sugammadex 4 mg/kg5.60.00.02.81.90.90.0

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Percentage of Participants Experiencing a Serious Adverse Event (SAE) Up To 7 Days After Administration of Study Intervention

As per the protocol primary analysis, the percentage of participants experiencing an SAE up to 7 days after administration of study intervention was reported. An SAE was an adverse event that: resulted in death; was life threatening; resulted in persistent or significant disability or incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly or birth defect; was an other important medical event, was a cancer; or was associated with an overdose. (NCT03346057)
Timeframe: Up to 7 days

InterventionPercentage of Participants (Number)
Sugammadex 2 mg/kg11.4
Sugammadex 4 mg/kg7.5
Sugammadex 16 mg/kg10.3
Neostigmine + Glycopyrrolate5.9

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Percentage of Participants Experiencing an Adverse Event (AE) Up To 7 Days After Administration of Study Intervention

As per the protocol primary analysis, the percentage of participants experiencing an AE up to 7 days after administration of study intervention was reported. An AE was defined as any untoward medical occurrence in a participant which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of the Sponsor's product was also an AE. (NCT03346057)
Timeframe: Up to 7 days

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg94.3
Sugammadex 4 mg/kg88.8
Sugammadex 16 mg/kg92.6
Neostigmine + Glycopyrrolate88.2

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Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events

The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events was identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias were defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachycardia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not have been considered an AE, as determined by investigator judgment. (NCT03346057)
Timeframe: Up to approximately 35 minutes post-administration

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg1.0
Sugammadex 4 mg/kg0.0
Sugammadex 16 mg/kg1.5
Neostigmine + Glycopyrrolate2.0

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Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events

The percentage of participants experiencing treatment-emergent sinus bradycardia events was identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia were defined as a heart rate <60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not have been considered an adverse event (AE), as determined by investigator judgment. (NCT03346057)
Timeframe: Up to approximately 35 minutes post-administration

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg1.0
Sugammadex 4 mg/kg1.9
Sugammadex 16 mg/kg7.4
Neostigmine + Glycopyrrolate7.8

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Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events

The percentage of participants experiencing treatment-emergent sinus tachycardia events was identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not have been considered an AE, as determined by investigator judgment. (NCT03346057)
Timeframe: Up to approximately 35 minutes post-administration

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg6.7
Sugammadex 4 mg/kg9.3
Sugammadex 16 mg/kg8.8
Neostigmine + Glycopyrrolate21.6

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Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events

The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events were identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias are defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachyarrhythmia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 35 minutes

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW0.0
Sugammadex 4 mg/kg ABW0.0
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)0.0
Sugammadex 2 mg/kg IBW2.6
Sugammadex 4 mg/kg IBW0.0
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)1.4
Neostigmine/Glycopyrrolate2.6

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Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events

The percentage of participants experiencing treatment-emergent bradycardia events were identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia is defined as a heart rate <60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not be considered an adverse event (AE), as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 35 minutes

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW5.3
Sugammadex 4 mg/kg ABW5.3
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)5.3
Sugammadex 2 mg/kg IBW2.6
Sugammadex 4 mg/kg IBW5.6
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)4.1
Neostigmine/Glycopyrrolate2.6

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Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis

The secondary efficacy analysis of TTR of participant TOF ratio to ≥0.9 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 76 minutes

InterventionMinutes (Geometric Mean)
Sugammadex 2 mg/kg ABW2.0
Sugammadex 4 mg/kg ABW1.9
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)2.0
Sugammadex 2 mg/kg IBW3.2
Sugammadex 4 mg/kg IBW3.5
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)3.3
Neostigmine/Glycopyrrolate23.1

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Percentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention

The percentage of participants experiencing an SAE following administration of study intervention was monitored. An SAE is an adverse event that: results in death; is life threatening; results in persistent or significant disability or incapacity; results in or prolongs a hospitalization; is a congenital anomaly or birth defect; is a cancer; or may jeopardize the participant, potentially requiring medical or surgical intervention. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 7 days

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW2.6
Sugammadex 4 mg/kg ABW0.0
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)1.3
Sugammadex 2 mg/kg IBW5.3
Sugammadex 4 mg/kg IBW8.3
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)6.8
Neostigmine/Glycopyrrolate7.9

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Percentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.9

Following administration of study intervention, the percentage of participants experiencing prolonged (>10 minutes) recovery to a TOF ratio ≥0.9 was calculated. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 76 minutes

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW7.9
Sugammadex 4 mg/kg ABW2.7
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)5.3
Sugammadex 2 mg/kg IBW5.4
Sugammadex 4 mg/kg IBW0.0
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)2.7
Neostigmine/Glycopyrrolate84.2

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Percentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention

The percentage of participants experiencing an AE following administration of study intervention was monitored. An AE is any unfavorable and unintended medical occurrence, symptom, or disease witnessed in a participant, regardless of whether or not a causal relationship with the study treatment can be demonstrated. Further, any worsening (i.e. any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that is temporally associated with the use of the study treatment is also considered an AE. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 7 days

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW94.7
Sugammadex 4 mg/kg ABW86.8
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)90.8
Sugammadex 2 mg/kg IBW94.7
Sugammadex 4 mg/kg IBW91.7
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)93.2
Neostigmine/Glycopyrrolate89.5

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Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events

The percentage of participants experiencing treatment-emergent sinus tachycardia events were identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 35 minutes

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW10.5
Sugammadex 4 mg/kg ABW13.2
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)11.8
Sugammadex 2 mg/kg IBW7.9
Sugammadex 4 mg/kg IBW2.8
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)5.4
Neostigmine/Glycopyrrolate7.9

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Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis

The efficacy analysis of TTR of participant TOF ratio to ≥0.7 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.7 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 61 minutes

InterventionMinutes (Geometric Mean)
Sugammadex 2 mg/kg ABW1.4
Sugammadex 4 mg/kg ABW1.3
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)1.4
Sugammadex 2 mg/kg IBW2.1
Sugammadex 4 mg/kg IBW2.0
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)2.1
Neostigmine/Glycopyrrolate10.9

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Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis

The efficacy analysis of TTR of participant TOF ratio to ≥0.8 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.8 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 69 minutes

InterventionMinutes (Geometric Mean)
Sugammadex 2 mg/kg ABW1.6
Sugammadex 4 mg/kg ABW1.5
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)1.5
Sugammadex 2 mg/kg IBW2.5
Sugammadex 4 mg/kg IBW2.6
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)2.5
Neostigmine/Glycopyrrolate16.6

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Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis

The primary efficacy analysis of TTR of TOF ratio to ≥0.9 was performed by estimating event rates within each treatment group using the Kaplan-Meier method. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 76 minutes

InterventionMinutes (Median)
Sugammadex 2 mg/kg ABW1.7
Sugammadex 4 mg/kg ABW1.8
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)1.8
Sugammadex 2 mg/kg IBW3.4
Sugammadex 4 mg/kg IBW3.3
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)3.3
Neostigmine/Glycopyrrolate34.5

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Percentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention

The percentage of participants experiencing an ECI following administration of study intervention was monitored. ECIs are a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW [2 mg/kg ABW plus 4 mg/kg ABW] and Sugammadex IBW [2 mg/kg IBW plus 4 mg/kg IBW]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW). (NCT03346070)
Timeframe: Up to 7 days

InterventionPercentage of participants (Number)
Sugammadex 2 mg/kg ABW0.0
Sugammadex 4 mg/kg ABW2.6
Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)1.3
Sugammadex 2 mg/kg IBW2.6
Sugammadex 4 mg/kg IBW2.8
Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)2.7
Neostigmine/Glycopyrrolate2.6

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Plasma Half-Life (t½) of Sugammadex [Part A]

The t½ of sugammadex, defined as the time required for the plasma concentration to decrease to 50% of maximum, was determined in each Part A arm. (NCT03351608)
Timeframe: 2 minutes (min), 15 min, 30 min, 60 min, 4-6 hours (hrs), and 10 hrs post-dose

InterventionHours (Median)
Part A: Sugammadex 2 mg (2 to <6 Years)1.15
Part A: Sugammadex 2 mg (6 to <12 Years)1.19
Part A: Sugammadex 2 mg (12 to <17 Years)1.49
Part A: Sugammadex 4 mg (2 to <6 Years)1.12
Part A: Sugammadex 4 mg (6 to <12 Years)1.56
Part A: Sugammadex 4 mg (12 to <17 Years)1.51

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Time to Recovery of Participant Train-of-Four (TOF) Ratio to ≥0.9 [Part B]

The time to recovery of TOF ratio to ≥0.9 after administration of study intervention was determined for each Part B arm. The TOF ratio is the ratio of the magnitude of the fourth (T4) and first (T1) thumb twitches elicited by 4 electrical stimulations of the ulnar nerve, indicating the current degree of NMB as a decimal from 0 (loss of T4 twitch) to 1 (no NMB). Values closer to 1 indicate less NMB. Per protocol, the efficacy analysis is based on comparison of the Part B: Sugammadex 2 mg arm versus the Part B: Neostigmine + (Glycopyrrolate or Atropine) arm. (NCT03351608)
Timeframe: Up to 30 minutes post-dose

InterventionMinutes (Geometric Mean)
Part B: Sugammadex 2 mg/kg1.6
Part B: Sugammadex 4 mg/kg1.9
Part B: Neostigmine + (Glycopyrrolate or Atropine)7.5

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Time to Recovery of Participant TOF Ratio to ≥0.7 [Part B]

The time to recovery of TOF ratio to ≥0.7 after administration of study intervention was determined for each Part B arm. The TOF ratio is the ratio of the magnitude of the fourth (T4) and first (T1) thumb twitches elicited by 4 electrical stimulations of the ulnar nerve, indicating the current degree of NMB as a decimal from 0 (loss of T4 twitch) to 1 (no NMB). Values closer to 1 indicate less NMB. (NCT03351608)
Timeframe: Up to 30 minutes post-dose

InterventionMinutes (Geometric Mean)
Part B: Sugammadex 2 mg/kg1.1
Part B: Sugammadex 4 mg/kg1.3
Part B: Neostigmine + (Glycopyrrolate or Atropine)3.7

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Time to Recovery of Participant TOF Ratio to ≥0.8 [Part B]

The time to recovery of TOF ratio to ≥0.8 after administration of study intervention was determined for each Part B arm. The TOF ratio is the ratio of the magnitude of the fourth (T4) and first (T1) thumb twitches elicited by 4 electrical stimulations of the ulnar nerve, indicating the current degree of NMB as a decimal from 0 (loss of T4 twitch) to 1 (no NMB). Values closer to 1 indicate less NMB. (NCT03351608)
Timeframe: Up to 30 minutes post-dose

InterventionMinutes (Geometric Mean)
Part B: Sugammadex 2 mg/kg1.3
Part B: Sugammadex 4 mg/kg1.5
Part B: Neostigmine + (Glycopyrrolate or Atropine)5.0

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Plasma Clearance (CL) of Sugammadex [Part A]

The CL of sugammadex, defined as the rate of elimination relative to plasma concentration, was determined in each Part A arm. (NCT03351608)
Timeframe: 2 minutes (min), 15 min, 30 min, 60 min, 4-6 hours (hrs), and 10 hrs post-dose

InterventionL/hr (Geometric Mean)
Part A: Sugammadex 2 mg (2 to <6 Years)2.30
Part A: Sugammadex 2 mg (6 to <12 Years)3.58
Part A: Sugammadex 2 mg (12 to <17 Years)4.68
Part A: Sugammadex 4 mg (2 to <6 Years)2.26
Part A: Sugammadex 4 mg (6 to <12 Years)3.43
Part A: Sugammadex 4 mg (12 to <17 Years)5.69

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Percentage of Participants With ≥1 Adverse Event (AE) [Parts A and B]

The percentage of participants with ≥1 AE(s) for up to 7 days after treatment was determined for each treatment group, pooled according to treatment received. An AE is defined as any unfavorable and unintended medical occurrence, symptom, or disease witnessed in a participant, regardless of whether or not a causal relationship with the study treatment can be demonstrated. (NCT03351608)
Timeframe: Up to 7 days

InterventionPercentage of Participants (Number)
Part B: Neostigmine + (Glycopyrrolate or Atropine)97.1
Parts A and B: Sugammadex 2 mg78.4
Parts A and B: Sugammadex 4 mg74.9

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Maximum Plasma Concentration (Cmax) of Sugammadex [Part A]

The Cmax of sugammadex, defined as the maximum plasma concentration, was determined in each Part A arm. (NCT03351608)
Timeframe: 2 minutes (min), 15 min, 30 min, 60 min, 4-6 hours (hrs), and 10 hrs post-dose

Interventionµg/mL (Geometric Mean)
Part A: Sugammadex 2 mg (2 to <6 Years)17.5
Part A: Sugammadex 2 mg (6 to <12 Years)32.2
Part A: Sugammadex 2 mg (12 to <17 Years)41.3
Part A: Sugammadex 4 mg (2 to <6 Years)47.1
Part A: Sugammadex 4 mg (6 to <12 Years)51.6
Part A: Sugammadex 4 mg (12 to <17 Years)61.9

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Area Under the Plasma Concentration-Time Curve (AUC) From Dosing to Infinity (AUC0-∞) of Sugammadex [Part A]

The AUCo-∞ for sugammadex, defined as the area under the plasma concentration versus time plot, was determined in each Part A arm. (NCT03351608)
Timeframe: 2 minutes (min), 15 min, 30 min, 60 min, 4-6 hours (hrs), and 10 hrs post-dose

Interventionhr*μg/mL (Geometric Mean)
Part A: Sugammadex 2 mg (2 to <6 Years)14.1
Part A: Sugammadex 2 mg (6 to <12 Years)18.8
Part A: Sugammadex 2 mg (12 to <17 Years)27.6
Part A: Sugammadex 4 mg (2 to <6 Years)26.9
Part A: Sugammadex 4 mg (6 to <12 Years)38.2
Part A: Sugammadex 4 mg (12 to <17 Years)49.2

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Apparent Volume of Distribution (Vz) of Sugammadex [Part A]

The Vz of sugammadex, defined as the amount of drug administered relative to plasma concentrations, was determined in each Part A arm. (NCT03351608)
Timeframe: 2 minutes (min), 15 min, 30 min, 60 min, 4-6 hours (hrs), and 10 hrs post-dose

InterventionLiters (Geometric Mean)
Part A: Sugammadex 2 mg (2 to <6 Years)3.58
Part A: Sugammadex 2 mg (6 to <12 Years)6.65
Part A: Sugammadex 2 mg (12 to <17 Years)10.8
Part A: Sugammadex 4 mg (2 to <6 Years)4.00
Part A: Sugammadex 4 mg (6 to <12 Years)8.22
Part A: Sugammadex 4 mg (12 to <17 Years)12.3

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Assessment of Self-rated Patient Questionaries' Using S-PSR

"Post-discharge Surgical Recovery Scale (S-PSR) The modified Swedish version S-PSR is based on the Post-discharge Surgical Recovery Scale and is a 14-item questionnaire to assess the recovery post-discharge regarding the patients' health status and activity (see further appendix 2). Each item is rated using a semantic differential scale and the total sum is multiplied by 100. The possible range is 10-100, with higher score indicating a more favourable postoperative recovery." (NCT03357393)
Timeframe: The assessment is done by the patient at home (or at ward if pro-longed hospital stay is necessary) in the evening on the day of bronchoscopy. It takes approximately 2 minutes to complete the questionnaire.

Interventionunits on a scale (Median)
Midazolam and Morphine-scopolamine55
PCS (Propofol) With Morphine-scopolamine56
PCS (Propofol) With Glycopyrronium Bromide54

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Bronchoscopist Evaluation Using a Likert-type Scale

the bronchoscopist assess their perception of cough, bronchial secretion respectively circumstances for a smooth performance of the bronchoscopy of procedure using the Likert-type scale (1. Very dissatisfied, 2. Dissatisfied, 3. Neither satisfied nor dissatisfied, 4. Satisfied, 5. Very satisfied). (NCT03357393)
Timeframe: Directly after completion of the procedure.

Interventionunits on a scale (Median)
Midazolam and Morphine-scopolamine5
PCS (Propofol) With Morphine-scopolamine4
PCS (Propofol) With Glycopyrronium Bromide4

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Discharge Assessment Using PADSS After 2 Hours Number of Patients Reaching PADSS Score 10 After 2 Hours

Post Anaesthetic Discharge Scoring System (PADSS).A measurement of the PADSS score is done by pulmonary nurse every 15 min after bronchoscopy is finished (when bronchoscope is removed) for 2 hours. The PADSS is used to clinically assess if the patient is ready to be discharged after anaesthesia/sedation and consist of five criteria: vital signs, ambulation, nausea and/or vomiting, pain and surgical bleeding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a total score of 10 are considered ready for discharge after 2 hours. (NCT03357393)
Timeframe: 2 hours after bronchoscopy is finished

InterventionParticipants (Count of Participants)
Midazolam and Morphine-scopolamine19
PCS (Propofol) With Morphine-scopolamine30
PCS (Propofol) With Glycopyrronium Bromide45

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Level of Sedation Using the Observer's Assessment of Alertness/Sedation (OAA/S) Scale

"Level of sedation is assessed every 5th minute during the procedure by the nurse anaesthetist using The Observer's Assessment of Alertness/Sedation (OAA/S) scale whereby a higher score represent a lighter sedation. Below is the scale descriped, Observation/score:~Responds readily to name spoken in normal tone/5 Lethargic response to name spoken in normal tone/4 Responds only after name is called loudly and/or repeatedly/3 Responds only after mild prodding or shaking/2 Does not respond to mild prodding or shaking/1" (NCT03357393)
Timeframe: Assessement are done every 5th minute from procedure start until end of procedure (extraction of bronchoscope), estimated period of time 0-60 minutes.

Interventionunits on a scale (Median)
Midazolam and Morphine-scopolamine3
PCS (Propofol) With Morphine-scopolamine2
PCS (Propofol) With Glycopyrronium Bromide2

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Number of Participants With Interventions Performed

Number of participants with interventions performed to maintain cardiovascular (if atropine or ephidrine has been given) and respiratory stability (if assisted ventilation, chin lift or painful stimulation has been performed). Assesed every five minutes during the procedure. (NCT03357393)
Timeframe: From procedure start until end of procedure (extraction of bronchoscope), estimated period of time 0-60 minutes.

InterventionParticipants (Count of Participants)
Midazolam and Morphine-scopolamine1
PCS (Propofol) With Morphine-scopolamine4
PCS (Propofol) With Glycopyrronium Bromide3

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Patients' Satisfaction Using a Likert-type Scale

overall satisfaction with the procedure using the Likert-type scale (1. Very dissatisfied, 2. Dissatisfied, 3. Neither satisfied nor dissatisfied, 4. Satisfied, 5. Very satisfied). The patient may comment any cause which made the satisfaction score high or low and if the patient would like to receive the same method of sedation during a future bronchoscopy. (NCT03357393)
Timeframe: After patient has recovered after bronchoscopy and before discharge home, estimated period of time 0-24 hours.

Interventionunits on a scale (Median)
Midazolam and Morphine-scopolamine5
PCS (Propofol) With Morphine-scopolamine5
PCS (Propofol) With Glycopyrronium Bromide5

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Quality of Recovery (QoR-23)

"Modified version of Quality of Recovery (QoR-23) Minimum value 23. Maximum value 115. A higher score indicate a better quality of recovery.~The questionnaire Quality of Recovery (QoR-23) is a 23 item questionnaire to assess recovery after day surgery regarding the patients' emotional state, physical comfort and physical independence (see further appendix 4). Each item is rated on a five-point scale (1-5) and the scores are summed." (NCT03357393)
Timeframe: The assessment is done by the patient at home (or at ward if pro-longed hospital stay is necessary) in the morning the day after bronchoscopy. It takes less than 1 minute to complete the assessment.

Interventionscore on a scale (Median)
Midazolam and Morphine-scopolamine100
PCS (Propofol) With Morphine-scopolamine102
PCS (Propofol) With Glycopyrronium Bromide100

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Oral/Enteral Intake

minutes from completion of scan to oral/enteral intake (NCT03513757)
Timeframe: up to 2 hours

Interventionminutes (Median)
Propofol33
Propofol Dexmedetomidine14

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Nitrous Oxide

documentation of use (NCT03513757)
Timeframe: up to 10 minutes

Interventionparticipants (Number)
Propofol18
Propofol Dexmedetomidine17

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Lidocaine Dose

lidocaine dose (mg/kg) (NCT03513757)
Timeframe: up to 90 minutes

Interventionmg/kg (Median)
Propofol1.00
Propofol Dexmedetomidine1.00

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Irritability

behavior deemed inappropriate and a deviation from child's normal though parental observation obtained through follow-up phone call (NCT03513757)
Timeframe: up to 48 hours

Interventionparticipants (Number)
Propofol3
Propofol Dexmedetomidine0

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Delirium

Pediatric Anesthesia Emergence Delirium (PAED) score greater than 12 as defined by Sikich and Lerman. 0 = no delirium, 20 = worst possible delirium; 5 categories scored from 0-4 additive for a maximum score of 20. Categories 1-3 are scored the same and categories ar scored inversely as described. 1. Child makes contact with caregiver, 2. child's actions are purposeful, 3. child is aware of his surroundings. For each of these category, score 0 for extremely, 1 for very much, 2 for quite a bit, 3 for just a little, 4 for not at all. The other 2 categories 4. Child is restless and 5 Child is inconsolable are scored as 0 for not at all, 1 for just a little, 2 for quite a bit, 3 for very much, 4 for extremely (NCT03513757)
Timeframe: up to 24 hours.

Interventionparticipants (Number)
Propofol0
Propofol Dexmedetomidine0

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Dexmedetomidine Dose

dexmedetomidine dose (mcg/kg) (NCT03513757)
Timeframe: up to 90 minutes

Interventionmcg/kg (Median)
Propofol0
Propofol Dexmedetomidine0.70

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Discharge Ready

minutes from completion of scan to discharge ready (NCT03513757)
Timeframe: up to 2 hours

Interventionminutes (Median)
Propofol40
Propofol Dexmedetomidine17

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Efficiency of Propofol Dexmedetomidine Sedation Compared With Propofol Infusion

Time (minutes) from anesthesia start to readiness for discharge from the department to home or clinic. (NCT03513757)
Timeframe: through study completion, an average of 2 hours

Interventionminutes (Median)
Propofol98
Propofol Dexmedetomidine77

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Eye Opening

minutes from completion of scan to spontaneous eye opening (NCT03513757)
Timeframe: up to 90 minutes

Interventionminutes (Median)
Propofol28
Propofol Dexmedetomidine3

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Glycopyrrolate Dose

glycopyrrolate dose (mcg/kg) (NCT03513757)
Timeframe: 5 minutes

Interventionmcg/kg (Median)
Propofol0
Propofol Dexmedetomidine4.2

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Total Propofol Administered

total propofol administered (mg/kg) (NCT03513757)
Timeframe: up to 90 minutes

Interventionmg/kg (Median)
Propofol10.6
Propofol Dexmedetomidine3.0

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Sevoflurane

sevoflurane induction time of 5 minutes (NCT03513757)
Timeframe: sevoflurane induction time up to 10 minutes

Interventionparticipants (Number)
Propofol18
Propofol Dexmedetomidine17

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Sleep Pattern

parental observation of deviation from child's normal habit obtained through follow-up phone call (NCT03513757)
Timeframe: up to 48 hours

Interventionparticipants (Number)
Propofol3
Propofol Dexmedetomidine2

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Frequency of Congruence of Nerve Integrity and Vocal Cord Functions

"Frequency of congruence - IOVL used in conjunction with routine intraoperative nerve monitoring to provide additional data on nerve integrity and vocal cord functions for patients undergoing neck procedures that place the recurrent and superior laryngeal nerves at risk for injury or postoperative dysfunction.~Video-captured vocal cord movement as well as the Nerveana Power Index (NPI) audio signal were recorded. Loss of signal was considered any NPI value <100, which corresponds to loss of audio signal. The NPI is specific to the Nerveana machine, and is an index of the nerve/muscle response power (or area under the curve) as a percentage of the threshold level of response. Thus, positive EMG signal (EMG+) was an NPI value >100. Positive IOVL (IOVL+) correlated with observed vocal cord movement on nerve stimulation; negative IOVL indicated no visible vocal cord movement. Discordances were considered to be contradictory IOVL and EMG (e.g., IOVL+ EMG-) findings for a particular nerve." (NCT03742141)
Timeframe: up to 3 months post-resection

Interventionnerves at risk (Count of Units)
EMG+ IOVL+EMG+ IOVL-EMG- IOVL-EMG- IOVL+
Intraoperative Video Laryngoscopy68131710

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Percentage of Subjects Who Have at Least a 50% Reduction in Gravimetrically-measured Sweat Production From Baseline at Week 2

Gravimetrically measured sweat production is based on the mean of the right and left hand measurements; confidence interval represents difference between vehicle and active group (NCT03880266)
Timeframe: Baseline, Week 2

InterventionParticipants (Count of Participants)
Group 1 Active1
Group 1 Vehicle1
Group 2 Active3
Group 2 Vehicle2
Group 3 Active4
Group 3 Vehicle0
Group 4 Active2
Group 4 Vehicle3

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Percentage of Subjects Who Have a ≥2 Grade Improvement in HDSS (Hyperhidrosis Disease Severity Scale) From Baseline at Week 2

"Hyperhidrosis Disease Severity Scale (HDSS) is a disease specific diagnostic tool that provides a qualitative measure of the severity of the subjects' condition based on how it affects daily activities.~1 (better), 2, 3, 4 (worse)" (NCT03880266)
Timeframe: Baseline, Week 2

InterventionParticipants (Count of Participants)
Group 1 Active3
Group 1 Vehicle0
Group 2 Active1
Group 2 Vehicle2
Group 3 Active1
Group 3 Vehicle2
Group 4 Active3
Group 4 Vehicle2

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Mean Percent Change From Baseline in Gravimetrically-measured Sweat Production at Week 2

Gravimetrically measured sweat production is based on the mean of the right and left hand measurements; calculation of percentage difference in sweat production at week 2 compared to baseline sweat production (NCT03880266)
Timeframe: Baseline, Week 2

InterventionPercent change (Mean)
Group 1 Active-17.1
Group 1 Vehicle16.5
Group 2 Active-7.5
Group 2 Vehicle-31.8
Group 3 Active-26.8
Group 3 Vehicle11.4
Group 4 Active-17.7
Group 4 Vehicle21.7

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Mean Change From Baseline to Week 2 in Hand Sweating Severity Score

The Hand Sweat Severity Score is a patient reported outcome, designed to measure the severity of palmar hyperhidrosis [score on a scale from 0 (better) -10 (worse)]. (NCT03880266)
Timeframe: Baseline, Week 2

Interventionscore on a scale (Mean)
Group 1 Active-2.14
Group 1 Vehicle-0.56
Group 2 Active-1.64
Group 2 Vehicle-3.03
Group 3 Active-2.53
Group 3 Vehicle-2.20
Group 4 Active-1.30
Group 4 Vehicle-1.34

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Mean Absolute Change From Baseline in Gravimetrically-measured Sweat Production at Week 2

Gravimetrically measured sweat production is based on the mean of the right and left hand measurements; average of the change in the gravimetric measurement of sweat produced at baseline compared with Week 2 (NCT03880266)
Timeframe: Baseline, Week 2

Interventionmg (Mean)
Group 1 Active-69.8
Group 1 Vehicle136.7
Group 2 Active-15.3
Group 2 Vehicle-159.4
Group 3 Active-113.5
Group 3 Vehicle38.1
Group 4 Active-58.6
Group 4 Vehicle102.0

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Heart Rate

Heart rate post-reversal prior to extubation (NCT03939923)
Timeframe: 0 minutes to 2 hours after study drug administration

Interventionbeats per minute (Mean)
Neostigmine/Glycopyrrolate81.5385
Sugammadex81.1622

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Blood Pressure (First Measurement of Systolic Blood Pressure Post Reversal)

Blood pressure; measure of systolic blood pressure of subject is obtained post-reversal prior to extubation of trachea (NCT03939923)
Timeframe: 0 minutes to 2 hours after study drug administration

InterventionmmHg (Mean)
Neostigmine/Glycopyrrolate105.6
Sugammadex112.1

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Peak Flow Rate

Peak flow rate - measured by peak flow meter post-extubation at 30-60 mins (NCT03939923)
Timeframe: 30-60 minutes post-extubation

InterventionL/min (Mean)
Neostigmine/Glycopyrrolate1.4609
Sugammadex1.416

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Tidal Volume

Tidal volume post-reversal prior to extubation (NCT03939923)
Timeframe: between 30 minutes to 1 hour after extubation

InterventionLiters (Mean)
Neostigmine/Glycopyrrolate1.16
Sugammadex1.0975

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Time to Extubation

"Time to extubation: West Virginia University Hospitals use an electronic medical record (EMR) to chart procedure stop. The definition for time to extubation is from the time the investigators chart procedure stop to the time of extubation." (NCT03939923)
Timeframe: 0 minutes of study drug to 3 days after study drug administration

InterventionMinutes (Mean)
Neostigmine/Glycopyrrolate10.4
Sugammadex6

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