Tiotropium +Olodaterol Fixed Dose Combination (FDC) Versus Tiotropium and Olodaterol in Chronic Obstructive Pulmonary Disease (COPD)
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Condition  Intervention  Phase 

Pulmonary Disease, Chronic Obstructive 
Drug: tiotropium + olodaterol Drug: tiotropium Drug: olodaterol Device: Respimat 
Phase 3 
Study Type:  Interventional 
Study Design:  Allocation: Randomized Intervention Model: Parallel Assignment Masking: DoubleBlind Primary Purpose: Treatment 
Official Title:  A Randomised, Doubleblind, Parallel Group Study to Assess the Efficacy and Safety of 52 Weeks of Once Daily Treatment of Orally Inhaled Tiotropium + Olodaterol Fixed Dose Combination (2.5 µg / 5 µg; 5 µg / 5 µg) (Delivered by the Respimat® Inhaler) Compared With the Individual Components (2.5 µg and 5 µg Tiotropium, 5 µg Olodaterol) (Delivered by the Respimat® Inhaler) in Patients With Chronic Obstructive Pulmonary Disease (COPD) [TOnado TM 2] 
 Forced Expiratory Volume in One Second (FEV1) Area Under the Curve (AUC) (03h) Response on Day 169 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 169 ]
FEV1 AUC(03h) was calculated as the area under the FEV1 time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres. FEV1 AUC(03h) response was defined as FEV1 AUC(03h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom. Number of participants analyzed are the number of patients contributing to the MMRM model in each treatment group.
 Trough FEV1 Response on Day 170 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 23 h and at 23 h 50 min after inhalation of study medication on Day 170 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours) and was calculated as the mean of the 2 FEV1 measurements performed at 23 h and at 23 h 50 min after inhalation of study medication at the clinic visit on the previous day.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an MMRM including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Saint George's Respiratory Questionnaire (SGRQ) Total Score on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274). [ Time Frame: Day 169 ]
The SGRQ is designed to measure health impairment in patients with COPD. It is divided into 2 parts: part 1 produces the symptoms score, and part 2 the activity and impacts scores. A total score is also produced. Each subscale score is the sum of the weights for the items in the subscale as a percent of the sum of the weights for a patient in the worst possible condition. The total score uses the same calculation except that the weights are summed over the entire questionnaire. The individual subscales as well as the total score can range from 0 to 100 with a lower score denoting a better health status.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 Mahler Transitional Dyspnoea Index (TDI) Focal Score on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 169 ]
Mahler Transitional Dyspnoea Index (TDI) focal score on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) is the key secondary endpoint.
The Mahler Dyspnoea questionnaire is an instrument which measures change from the baseline state The TDI focal score was used to measure the effect of Tio+Olo FDC on patients' dyspnoea after 24 weeks of treatment (Day 169). The focal score is the sum of the subscale scores for Functional Impairment, Magnitude of Effort and Magnitude of Task. Scores for each subscale range from 3 to 3 so that the Focal score ranges from 9 to 9. For all subscale scores and the Focal score a higher value indicates a better outcome.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 FEV1 AUC(03h) Response on Day 1 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on the first day of randomized treatment ]
FEV1 AUC(03h) was calculated as the area under the FEV1 time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FEV1 AUC(03h) response was defined as FEV1 AUC(03h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 FEV1 AUC(03h) Response on Day 85 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 85 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 85 ]
FEV1 AUC(03h) was calculated as the area under the FEV1 time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FEV1 AUC(03h) response was defined as FEV1 AUC(03h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 FEV1 AUC(03h) Response on Day 365 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 365 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 365 ]
FEV1 AUC(03h) was calculated as the area under the FEV1 time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FEV1 AUC(03h) response was defined as FEV1 AUC(03h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FEV1 Response on Day 15 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 10 min predose on day 15 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FEV1 Response on Day 43 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 10 min predose on day 43 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FEV1 Response on Day 85 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 1hr and 10 min predose on day 85 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FEV1 Response on Day 169 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 1hr and 10 min predose on day 169 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FEV1 Response on Day 365 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 1 hr and 10 min predose on day 365 ]
Trough FEV1 was defined as the FEV1 value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FEV1 response was defined as trough FEV1 minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose of randomised treatment at Day1.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Forced Vital Capacity (FVC) AUC(03h) Response on Day 1 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on the first day of randomized treatment ]
FVC AUC(03h) was calculated as the area under the FVC time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FVC AUC(03h) response was defined as FVC AUC(03h) minus baseline FVC.Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Forced Vital Capacity (FVC) AUC(03h) Response on Day 85 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 85 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 85 ]
FVC AUC(03h) was calculated as the area under the FVC time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FVC AUC(03h) response was defined as FVC AUC(03h) minus baseline FVC.Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Forced Vital Capacity (FVC) AUC(03h) Response on Day 169 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 169 ]
FVC AUC(03h) was calculated as the area under the FVC time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FVC AUC(03h) response was defined as FVC AUC(03h) minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Forced Vital Capacity (FVC) AUC(03h) Response on Day 365 [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 365 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h postdose on Day 365 ]
FVC AUC(03h) was calculated as the area under the FVC time curve from 0 to 3 h postdose using the trapezoidal rule, divided by the duration (3 h) to report in litres.
FVC AUC(03h) response was defined as FVC AUC(03h) minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FVC Response on Day 15 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 10 min predose on day 15 ]
Trough FVC was defined as the FVC value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FVC response was defined as trough FVC minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
 Trough FVC Response on Day 43 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 10 min predose on day 43 ]
Trough FVC was defined as the FVC value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FVC response was defined as trough FVC minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
 Trough FVC Response on Day 85 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and on day 85 ]
Trough FVC was defined as the FVC value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FVC response was defined as trough FVC minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
 Trough FVC Response on Day 170 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and at 23h and at 23h 50 min after inhalation of study medication on day 170 ]
Trough FVC was defined as the FVC value at the end of the dosing interval (24 hours) and was calculated as the mean of the 2 FVC measurements performed at 23h and at 23h 50 min after inhalation of study medication at the clinic visit on the previous day.
Trough FVC response was defined as trough FVC minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted means (SE) were obtained from fitting an MMRM including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
 Trough FVC Response on Day 365 [ Time Frame: 1 h and 10 min prior to dose on the first day of randomized treatment (baseline) and on day 365 ]
Trough FVC was defined as the FVC value at the end of the dosing interval (24 hours), calculated as the mean of the predose measurements.
Trough FVC response was defined as trough FVC minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures (MMRM) model in each treatment group.
The adjusted means (SE) were obtained from fitting an Mixed effect model repeated measures (MMRM) including fixed effects of treatment, planned test day, treatmentbytest day interaction, baseline and baselinebytest day interaction, patient as random effect, and spatial power covariance structure for within−patient errors and KenwardRoger approximation for denominator degrees of freedom.
 FEV1 AUC(012h) Response in Subset of Patients With 12hour Pulmonary Function Test (PFT) on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h postdose on Day 169 ]
FEV1 AUC(012h) was calculated as the area under the FEV1 time curve from 0 to 12 h postdose using the trapezoidal rule, divided by the duration (12 h) to report in litres.
FEV1 AUC(012h) response was defined as FEV1 AUC(012h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted mean (SE) were obtained from fitting an ANCOVA model with categorical effect of treatment and baseline as covariate.
Number of participants analyzed are the number of patients contributing to the ANCOVA model in each treatment group.
 FEV1 AUC(024h) Response in Subset of Patients With 12hour PFTs on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 23 h, 23 h and 50 min postdose on Day 169 ]
FEV1 AUC(024h) was calculated as the area under the FEV1 time curve from 0 to 24 h postdose using the trapezoidal rule, divided by the duration (24 h) to report in litres. FEV1 AUC(024h) response was defined as FEV1 AUC(024h) minus baseline FEV1. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted mean (SE) were obtained from fitting an ANCOVA model with categorical effect of treatment and baseline as covariate.
Number of participants analyzed are the number of patients contributing to the ANCOVA model in each treatment group.
 FVC AUC(012h) Response in Subset of Patients With 12hour PFTs on Day 169 From Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h postdose on Day 169 ]
FVC AUC(012h) was calculated as the area under the FVC time curve from 0 to 12 h postdose using the trapezoidal rule, divided by the duration (12 h) to report in litres.
FVC AUC(012h) response was defined as FVC AUC(012h) minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted mean (SE) were obtained from fitting an ANCOVA model with categorical effect of treatment and baseline as covariate. Number of participants analyzed are the number of patients contributing to the ANCOVA model in each treatment group.
 FVC AUC(024h) Response in Subset of Patients With 12hour PFTs on Day 169 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: 1 hour (h) and 10 minutes (min) prior to dose to on the first day of randomized treatment and on Day 169 and 5 min, 15 min, 30 min, 1 h, 2 h, 3 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 23 h, 23 h and 50 min postdose on Day 169 ]
FVC AUC(024h) was calculated as the area under the FVC time curve from 0 to 24 h postdose using the trapezoidal rule, divided by the duration (24 h) to report in litres.
FVC AUC(024h) response was defined as FVC AUC(024h) minus baseline FVC. Baseline was defined as the mean of the 2 predose measurements performed 1 h and 10 min prior to administration of the first dose at visit 2 (day 1).
The adjusted mean (SE) were obtained from fitting an ANCOVA model with categorical effect of treatment and baseline as covariate.
Number of participants analyzed are the number of patients contributing to the ANCOVA model in each treatment group.
 Saint George's Respiratory Questionnaire (SGRQ) Total Score on Day 85 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 85 ]
The SGRQ is designed to measure health impairment in patients with COPD. It is divided into 2 parts: part 1 produces the symptoms score, and part 2 the activity and impacts scores. A total score is also produced. Each subscale score is the sum of the weights for the items in the subscale as a percent of the sum of the weights for a patient in the worst possible condition. The total score uses the same calculation except that the weights are summed over the entire questionnaire. The individual subscales as well as the total score can range from 0 to 100 with a lower score denoting a better health status.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 Saint George's Respiratory Questionnaire (SGRQ) Total Score on Day 365 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 365 ]
The SGRQ is designed to measure health impairment in patients with COPD. It is divided into 2 parts: part 1 produces the symptoms score, and part 2 the activity and impacts scores. A total score is also produced. Each subscale score is the sum of the weights for the items in the subscale as a percent of the sum of the weights for a patient in the worst possible condition. The total score uses the same calculation except that the weights are summed over the entire questionnaire. The individual subscales as well as the total score can range from 0 to 100 with a lower score denoting a better health status.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 Mahler Transitional Dyspnoea Index (TDI) Focal Score on Day 43 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 43 ]
Mahler TDI focal score on Day 43 From the two twin trials, present 1237.6 (NCT01431287) and 1237.5 (NCT01431274).
The Mahler Dyspnoea questionnaire is an instrument which measures change from the baseline state The TDI focal score was used to measure the effect of Tio+Olo FDC on patients' dyspnoea after 24 weeks of treatment (Day 169). The focal score is the sum of the subscale scores for Functional Impairment, Magnitude of Effort and Magnitude of Task. Scores for each subscale range from 3 to 3 so that the Focal score ranges from 9 to 9. For all subscale scores and the Focal score a higher value indicates a better outcome.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 Mahler Transitional Dyspnoea Index (TDI) Focal Score on Day 85 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 85 ]
Mahler TDI focal score on Day 85 From the two twin trials, present 1237.6 (NCT01431287) and 1237.5 (NCT01431274).
The Mahler Dyspnoea questionnaire is an instrument which measures change from the baseline state The TDI focal score was used to measure the effect of Tio+Olo FDC on patients' dyspnoea after 24 weeks of treatment (Day 169). The focal score is the sum of the subscale scores for Functional Impairment, Magnitude of Effort and Magnitude of Task. Scores for each subscale range from 3 to 3 so that the Focal score ranges from 9 to 9. For all subscale scores and the Focal score a higher value indicates a better outcome.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
 Mahler Transitional Dyspnoea Index (TDI) Focal Score on Day 365 From the Two Twin Trials, Present 1237.6 (NCT01431287) and 1237.5 (NCT01431274) [ Time Frame: Day 365 ]
Mahler TDI focal score on Day 365 From the two twin trials, present 1237.6 (NCT01431287) and 1237.5 (NCT01431274).
The Mahler Dyspnoea questionnaire is an instrument which measures change from the baseline state The TDI focal score was used to measure the effect of Tio+Olo FDC on patients' dyspnoea after 24 weeks of treatment (Day 169). The focal score is the sum of the subscale scores for Functional Impairment, Magnitude of Effort and Magnitude of Task. Scores for each subscale range from 3 to 3 so that the Focal score ranges from 9 to 9. For all subscale scores and the Focal score a higher value indicates a better outcome.
Number of participants analyzed are the number of patients contributing to the mixed effect repeated measures model (MMRM) in each treatment group.
Enrollment:  2539 
Study Start Date:  September 2011 
Study Completion Date:  November 2013 
Primary Completion Date:  November 2013 (Final data collection date for primary outcome measure) 
Arms  Assigned Interventions 

Experimental: tiotropium+olodaterol high dose FDC
Once daily 2 puffs solution for inhalation Respimat

Drug: tiotropium + olodaterol
fixed dose combination
Device: Respimat
Respimat inhaler

Experimental: tiotropium+olodaterol low dose FDC
Once daily 2 puffs solution for inhalation Respimat

Drug: tiotropium + olodaterol
fixed dose combination
Device: Respimat
Respimat inhaler

Active Comparator: olodaterol
Once daily 2 puffs solution for inhalation Respimat

Drug: olodaterol
one dose only
Device: Respimat
Respimat inhaler

Active Comparator: tiotropium low dose
Once daily 2 puffs solution for inhalation Respimat

Drug: tiotropium
low dose or high dose
Device: Respimat
Respimat inhaler

Active Comparator: tiotropium high dose
Once daily 2 puffs solution for inhalation Respimat

Drug: tiotropium
low dose or high dose
Device: Respimat
Respimat inhaler

Ages Eligible for Study:  40 Years and older (Adult, Senior) 
Sexes Eligible for Study:  All 
Accepts Healthy Volunteers:  No 
Inclusion criteria:
 Diagnosis of chronic obstructive pulmonary disease.
 Relatively stable airway obstruction with post FEV1< 80% predicted normal and post FEV1/FVC <70%.
 Male or female patients, 40 years of age or older.
 Smoking history of more than 10 pack years.
Exclusion criteria:
 Significant disease other than COPD
 Clinically relevant abnormal lab values.
 History of asthma.
 Diagnosis of thyrotoxicosis
 Diagnosis of paroxysmal tachycardia
 History of myocardial infarction within 1 year of screening visit
 Unstable or lifethreatening cardiac arrhythmia.
 Hospitalization for heart failure within the past year.
 Known active tuberculosis.
 Malignancy for which patient has undergone resection, radiation therapy or chemotherapy within last five years
 History of lifethreatening pulmonary obstruction.
 History of cystic fibrosis.
 Clinically evident bronchiectasis.
 History of significant alcohol or drug abuse.
 Thoracotomy with pulmonary resection
 Oral ßadrenergics.
 Oral corticosteroid medication at unstable doses
 Regular use of daytime oxygen therapy for more than one hour per day
 Pulmonary rehabilitation program in the six weeks prior to the screening visit
 Investigational drug within one month or six half lives (whichever is greater) prior to screening visit
 Known hypersensitivity to ßadrenergic drugs, anticholinergics, BAC, EDTA
 Pregnant or nursing women.
 Women of childbearing potential not using a highly effective method of birth control
 Patients who are unable to comply with pulmonary medication restrictions
Please refer to this study by its ClinicalTrials.gov identifier: NCT01431287
Show 240 Study Locations
Study Chair:  Boehringer Ingelheim  Boehringer Ingelheim 
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party:  Boehringer Ingelheim 
ClinicalTrials.gov Identifier:  NCT01431287 History of Changes 
Other Study ID Numbers:  1237.6 200901066922 
Study First Received:  September 8, 2011 
Results First Received:  June 19, 2015 
Last Updated:  June 19, 2015 
Additional relevant MeSH terms:
Lung Diseases Lung Diseases, Obstructive Pulmonary Disease, Chronic Obstructive Chronic Disease Respiratory Tract Diseases Disease Attributes Pathologic Processes Tiotropium Bromide Olodaterol Bronchodilator Agents Autonomic Agents Peripheral Nervous System Agents 
Physiological Effects of Drugs AntiAsthmatic Agents Respiratory System Agents Parasympatholytics Cholinergic Antagonists Cholinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Adrenergic beta1 Receptor Agonists Adrenergic betaAgonists Adrenergic Agonists Adrenergic Agents 
ClinicalTrials.gov processed this record on January 23, 2017