> Trialight public data. Index of pages: https://trialight.com/llms.txt
> Web page: https://trialight.com/data/trial/a-study-comparing-efficacy-safety-and-tolerability-of-the-9c56f08f-6d7f-440a-8b9a-37eada504345
> Record changed: 2026-10-13

# A Study Comparing Efficacy, Safety and Tolerability of the Fixed Dose Triple Combination CHF 5993 With the Fixed Dose Dual Combination CHF 1535 in Subjects With COPD

NCT04320342

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Phase

Phase 3

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Recruitment status

Completed

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Participants

3,433

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Lead sponsor

Chiesi Farmaceutici S.p.A.

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Start date

2022-04-28

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

Number of sites

436

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Title and summary

**Summary**

The purpose of this study is to compare CHF 5993 with CHF 1535 in improving lung function, reducing moderate and severe COPD exacerbations, and other clinical efficacy and safety outcomes in the target subject population.

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Acronym**

TRITON

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Short title**

A Study Comparing Efficacy, Safety and Tolerability of the Fixed Dose Triple Combination CHF 5993 With the Fixed Dose Dual Combination CHF 1535 in Subjects With COPD

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Official title**

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 Glycopyrronium Bromide (CHF 5993) With the Fixed Dose Dual Combination of Beclomethasone Dipropionate Plus Formoterol Fumarate (CHF 1535), Both Administered Via pMDI in Subjects With Chronic Obstructive Pulmonary Disease (COPD)

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Status and phase

**Control arm**

Active comparator

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Registry reports results**

No

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Listing at source**

Listed

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Recruitment status**

Completed

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Phase**

Phase 3

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Study type**

Interventional

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Dates

**Completion date**

2026-01-12

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**First posted**

2020-03-25

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Registry last updated**

2026-01-30

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Primary completion date**

2026-01-12

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Start date**

2022-04-28

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Size and sites

**Actual participants**

3,433

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Participants**

3,433

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Participant count basis**

Actual

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Protocol amendments**

4

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Number of sites**

436

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Sponsor and oversight

**Data monitoring committee**

Yes

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Registry sponsor category**

Industry

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Lead sponsor**

Chiesi Farmaceutici S.p.A.

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Source registry**

ClinicalTrials.gov

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Identifiers

**Registry ID**

NCT04320342

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**ClinicalTrials.gov ID**

NCT04320342

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

**Registry record**

Open registry record

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Study design

**Allocation**

Randomised

**Model**

Parallel groups

**Purpose**

Treatment

**Masking**

Quadruple masking

**Masked roles**

Participants, Care providers, Investigators, Outcome assessors

Sources for study design

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Outcomes

### Primary outcomes

1. Change from baseline in pre-dose morning Forced Expiratory Volume in the 1st second (FEV1) at Week 28  
Timeframe: Week 28

### Secondary outcomes

1. Change from baseline in 2-hour post-dose morning FEV1 at Week 28  
Timeframe: Week 28
2. Rate of moderate and severe COPD exacerbations over 52 weeks of treatment  
Timeframe: 52-week treatment period  
Annualized rate of moderate and severe COPD exacerbations as observed during the 52-week study treatment period.
3. Change from baseline in pre-dose morning FEV1 at designated clinic visits  
Timeframe: Week 4, Week 10, Week 40, & Week 52
4. Change from baseline in 2-hour post-dose morning FEV1 designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 40, & Week 52
5. Change from pre-dose to 2-hour post-dose morning FEV1 at designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 28, Week 40, & Week 52
6. FEV1 response (change from baseline in pre-dose morning FEV1 ≥100ml) at designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 28, Week 40, & Week 52
7. Time to first moderate or severe COPD exacerbation  
Timeframe: 52-week treatment period
8. Rate of severe COPD exacerbations over 52 weeks of treatment  
Timeframe: 52-week treatment period  
Annualized rate of severe COPD exacerbations as observed during 52-week treatment period
9. Time to first severe COPD exacerbation  
Timeframe: 52-week treatment period
10. Saint George's Respiratory Questionnaire (SGRQ) response (a decrease from baseline in total score ≥4) at designated clinic visits  
Timeframe: Week 4, Week 10, Week 28, Week 40, & Week 52
11. Change from baseline in the SGRQ total score and domain scores at each designated clinic visit  
Timeframe: Week 4, Week 10, Week 28, Week 40, & Week 52
12. Change from baseline to each inter-visit period in the percentage of days without intake of rescue medication  
Timeframe: Day 1-Week 4, Week 4-Week 10, Week 10-Week 28, Week 28-Week 40, Week 40-Week 52  
Change from baseline (defined as the 2-week run-in period prior to randomization) to each inter-visit period (defined as the period of time between designated clinic visits) in percentage of days without rescue medication
13. Change from baseline to each inter-visit period in the average use of rescue medication (number of puffs/day)  
Timeframe: Day 1-Week 4, Week 4-Week 10, Week 10-Week 28, Week 28-Week 40, Week 40-Week 52  
Change from baseline (defined as the 2-week run-in period prior to randomization) in the average number of puffs per day of rescue medication for each inter-visit period (defined as the period of time between designated clinic visits).
14. Change from baseline in pre-dose morning Forced Vital Capacity (FVC) at designated clinic visits  
Timeframe: Week 4, Week 10, Week 28, Week 40, & Week 52
15. Change from baseline in 2-hour post-dose morning FVC at designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 28, Week 40, & Week 52  
Change from baseline (defined as the pre-dose value on Day 1) in 2-hour post-dose morning FVC at designated clinic visits
16. Change from pre-dose to 2-hour post-dose morning FVC at designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 28, Week 40, & Week 52
17. Change from baseline to each inter-visit period in the average E-RS total score and domain scores  
Timeframe: Day 1-Week 4, Week 4-Week 10, Week 10-Week 28, Week 28-Week 40, Week 40-Week 52  
Change from baseline (defined as the 2-week run-in period prior to randomization) in the average E-RS total score and E-RS domain scores for the period of time between designated clinic visits.
18. Change from baseline in COPD Assessment Test (CAT) score at designated clinic visit  
Timeframe: Week 4, Week 10, Week 28, Week 40, & Week 52  
The CAT is composed of 8 questions to measure the impact of COPD on daily life, which are scored from 0 to 5 with higher scores reflecting greater impact.
19. CAT response (decrease from baseline ≥2 points) at designated clinic visits  
Timeframe: Week 4, Week 10, Week 28, Week 40, & Week 52
20. Modified Medical Research Council (mMRC) dyspnea scale at designated clinic visits  
Timeframe: Day 1, Week 4, Week 10, Week 28, Week 40, & Week 52  
Descriptive statistics of the mMRC dyspnea scale score at designated clinic visits. The mMRC dyspnea scale is graded from 0 to 4, with higher grades reflecting greater severity.
21. Change from baseline in health-related quality of life (decrease from baseline in total SGRQ score ≥4) over 52 weeks of treatment.  
Timeframe: 52-week treatment period

Sources for outcomes

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Eligibility

**Sex**

All

**Age groups**

Adults, Older adults

**Minimum age**

40 Years

**Healthy volunteers**

No

### Inclusion criteria

- Signed and dated written informed consent must be obtained prior to initiating any study-related procedures
- Outpatient
- Male or female subjects aged ≥40 years
- Female subjects:

  1. WOCBP fulfilling one of the following criteria: i. WOCBP with fertile male partners: they and/or their partner must be willing to use a highly effective birth control method from the signing of the informed consent form and until the follow-up contact or ii. WOCBP with non-fertile male partners (contraception is not required in this case).
  2. Female subjects of non-childbearing potential defined as physiologically incapable of becoming pregnant (i.e. post-menopausal or permanently sterile as per definitions given in Appendix 5). Tubal ligation or partial surgical interventions are not acceptable. If indicated, as per investigator's request, post-menopausal status may be confirmed by follicle-stimulating hormone levels (according to local laboratory ranges)
- COPD diagnosis for at least 12 months before the screening visit in accordance with the definition by the GOLD 2020 Report
- Current or ex-smokers who quit smoking at least 6 months prior to screening with a smoking history of at least 10 pack-years \[pack-years = (number of cigarettes per day x number of years)/20\]
- COPD Assessment Test (CAT) score ≥10
- A pre- and post-bronchodilator FEV1/FVC ratio <0.70 at screening
- A post-bronchodilator FEV1 <50% predicted normal at screening and a documented history of ≥1 moderate or severe COPD exacerbation in the previous 12 months OR a post-bronchodilator FEV1 ≥50% and <80% of predicted normal at screening and a documented history of ≥2 moderate COPD exacerbations or ≥1 severe COPD exacerbation in the previous 12 months
- Subjects receiving daily inhaled maintenance therapy for their COPD, at a stable dose for at least 3 months prior to the screening and randomization visits
- Documentation (including imagery and report) of chest x-ray (CXR) or CT scan performed within 6 months prior to the screening visit, without evidence of significant abnormalities (other than those related to the presence of COPD).
- A cooperative attitude and ability to demonstrate correct use of the pMDI inhalers and eDiary.

### Exclusion criteria

- Female subjects who are pregnant (as evident by a positive urine hCG or serum β-hCG test) or lactating
- Subjects using the following medications prior to the screening visit and during the run-in period:

  1. Systemic/oral/parenteral corticosteroids in the prior 4 weeks
  2. Use of antibiotics for a lower respiratory tract infection (e.g. pneumonia) or COPD exacerbation in the prior 4 weeks
  3. Any long-term chronic maintenance use of antibiotic treatment in the prior 4 weeks
  4. Oral xanthine derivatives (e.g. theophylline) in the prior 7 days
- A moderate or severe COPD exacerbation or a respiratory tract infection (e.g., pneumonia) that has not resolved ≤14 days prior to the screening visit or during the run-in period
- Current treatment with non-cardioselective β-blockers
- Requirement of long term (> 15 hours daily) oxygen therapy
- Known respiratory disorders other than COPD which may impact the efficacy of the study drug according to investigator's judgement.
- Lung transplant surgery or lung volume reduction surgery (subjects with lung volume reduction surgery are excluded if the procedure was performed within 1 year before the Screening visit)
- Medical diagnosis of narrow-angle glaucoma, prostatic hypertrophy or bladder neck obstruction that, in the opinion of the investigator, would prevent use of anticholinergic agents
- History of hypersensitivity to M3 receptor antagonists, β2 agonists, corticosteroids or any of the excipients contained in any of the study drugs used in the trial which may raise contra-indications or impact the efficacy of the study drug according to the investigator's judgement
- Subject has severe, acute or uncontrolled cardiovascular condition (such as but not limited to unstable ischemic heart disease, NYHA Class IV, left ventricular failure, acute myocardial infarction or unstable angina) in the last 6 months
- An abnormal and clinically significant 12-lead ECG at either the screening or randomization visit. This is characterized as but not limited to any of the following findings:

  1. Atrial fibrillation (AF) with rapid ventricular response > 120 bpm
  2. Ventricular tachycardias (sustained, non-sustained \[>3 up to 30 sec\])
  3. Evidence of Mobitz Type II second degree or third-degree atrioventricular block
  4. Prolonged QTcF (>450ms for males, or >470ms for females). This criterion is not applicable for subjects with a pacemaker or permanent AF.
- Clinically significant laboratory abnormalities indicating a significant or unstable concomitant disease which may impact the efficacy or the safety of the study drug according to investigator's judgement
- Unstable or uncontrolled concurrent disease which may impact the efficacy or safety of the study drug or the subject's participation in the study according to investigator's judgment
- Malignancy that has not been in complete remission for at least 1 year or any untreated localized carcinomas
- History of alcohol abuse and/or substance/drug abuse within 12 months prior to the screening visit
- Receipt of any other investigational drug within 1 month or 5 half-lives (whichever is greater) prior to the screening visit or have been previously randomized in this trial, or are currently participating in another clinical trial
- Currently in the acute phase of a pulmonary rehabilitation program within 4 weeks before the screening visit or planning to enroll in the acute phase of such a program during the study. Subjects who are in the maintenance phase of a pulmonary rehabilitation program are not excluded
- Mentally or legally incapacitated, or subjects incarcerated as a result of an official or judicial order
- Major surgery in the 3 months prior to the screening visit or have a planned surgery during the trial
- Non-satisfactory compliance with the eDiary (<65% or >135%) during the run-in period
- Subjects requiring the use of spacer device or nebulizer for administration of maintenance COPD therapies.
- Veins unsuitable for repeat venipuncture
- Blood donation or blood loss (≥450mL) in the 4 weeks before randomization

Sources for eligibility

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Sites

- Chiesi Clinical Trial Site 840350Birmingham, United States
- Chiesi Clinical Trial Site 840186Dothan, United States
- Chiesi Clinical Trial Site 840258Foley, United States
- Chiesi Clinical Trial Site 840279Jasper, United States
- Chiesi Clinical Trial Site 840433Mobile, United States
- Chiesi Clinical Trial Site 840206Montgomery, United States
- Chiesi Clinical Trial Site 840249Muscle Shoals, United States
- Chiesi Clinical Trial Site 840406Chandler, United States
- Chiesi Clinical Trial Site 840402Peoria, United States
- Chiesi Clinical Trial Site 840349Tucson, United States
- Chiesi Clinical Trial Site 840404Covina, United States
- Chiesi Clinical Trial Site 840209Escondido, United States
- Chiesi Clinical Trial Site 840427La Palma, United States
- Chiesi Clinical Trial Site 840358Lomita, United States
- Chiesi Clinical Trial Site 840173Newport Beach, United States
- Chiesi Clinical Trial Site 840208Northridge, United States
- Chiesi Clinical Trial Site 840277Northridge, United States
- Chiesi Clinical Trial Site 840364Redding, United States
- Chiesi Clinical Trial Site 840226Sacramento, United States
- Chiesi Clinical Trial Site 840405Sacramento, United States
- Chiesi Clinical Trial Site 840107San Diego, United States
- Chiesi Clinical Trial Site 840373Santa Ana, United States
- Chiesi Clinical Trial Site 840164Upland, United States
- Chiesi Clinical Trial Site 840174West Covina, United States
- Chiesi Clinical Trial Site 840144Westminster, United States

And 411 more, listed on the interactive page.

Sources for sites

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## References

- PubMed 22743675  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/22743675/)
Background
- PubMed 16452599  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/16452599/)
Background
- PubMed 23245604  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/23245604/)
Background
- PubMed 17132052  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/17132052/)
Background
- PubMed 19818867  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/19818867/)
Background
- PubMed 10377201  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/10377201/)
Background
- PubMed 19720809  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/19720809/)
Background
- PubMed 30362922  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/30362922/)
Background
- PubMed 29668352  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/29668352/)
Background
- PubMed 19644045  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/19644045/)
Background
- PubMed 22040533  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/22040533/)
Background
- PubMed 21975275  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/21975275/)
Background
- PubMed 28375647  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/28375647/)
Background
- PubMed 30232048  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/30232048/)
Background
- PubMed 27598678  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/27598678/)
Background
- PubMed 28385353  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/28385353/)
Background
- PubMed 29429593  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/29429593/)
Background
- PubMed 24953015  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/24953015/)
Background
- PubMed 21835018  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/21835018/)
Background
- PubMed 31815521  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/31815521/)
Background
- PubMed 24621681  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/24621681/)
Background
- PubMed 16055882  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/16055882/)
Background
- PubMed 21119213  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/21119213/)
Background
- PubMed 3492164  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/3492164/)
Background
- PubMed 9603117  
Source: [pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/9603117/)
Background

And 8 more, listed on the interactive page.

- Related resource (goldcopd.org)  
Source: [goldcopd.org](https://goldcopd.org/gold-reports/)
- Related resource (www.ema.europa.eu)  
Source: [www.ema.europa.eu](https://www.ema.europa.eu/en/documents/scientific-guideline/draft-ich-e9-r1-addendum-estimands-sensitivity-analysis-clinical-trials-guideline-statistical%5Fen.pdf)
- Related resource (www.thoracic.org)  
Source: [www.thoracic.org](http://www.thoracic.org/members/assemblies/assemblies/srn/questionaires/copd.php)
- Related resource (www.verywellhealth.com)  
Source: [www.verywellhealth.com](https://www.verywellhealth.com/guidelines-for-the-mmrc-dyspnea-scale-914740)

### Other registry identifiers

- 2020-002389-16

Sources for references

Source: [clinicaltrials.gov](https://clinicaltrials.gov/study/NCT04320342)

## Related records

### Drugs (3)

- [Beclomethasone dipropionate](https://trialight.com/data/asset/beclomethasone-dipropionate-068d01cb-b921-4eda-85ad-1921f6683476.md)
- [Formoterol fumarate](https://trialight.com/data/asset/formoterol-fumarate-235f1f49-5d38-4e21-b612-da2d6d446b33.md)
- [Glycopyrronium bromide](https://trialight.com/data/asset/glycopyrronium-bromide-3e811428-27d6-4276-96b9-b0b17847e0e3.md)

### Lead sponsors (1)

- [Chiesi Farmaceutici S.p.A.](https://trialight.com/data/company/chiesi-farmaceutici-s-p-a-5660c527-7b1d-469a-a2db-d1ba8061415e.md)

### Conditions (2)

- [Chronic obstructive pulmonary disease](https://trialight.com/data/condition/chronic-obstructive-pulmonary-disease-8e23f74b-95b9-5920-a241-c0278555234f.md) Primary condition
- [COPD, severe early onset](https://trialight.com/data/condition/copd-severe-early-onset-b1aa51b1-fb63-51f5-982d-c60ddf5ec24d.md)

### Targets (4)

- [ADRB2](https://trialight.com/data/target/adrb2-dd50b672-19f0-5015-be62-c6f5861dc510.md)
- [CHRM1](https://trialight.com/data/target/chrm1-e35fe02d-a288-5062-830d-01da44f5bd85.md)
- [CHRM3](https://trialight.com/data/target/chrm3-0610da06-d23d-5bc0-b133-4b5bb330f58e.md)
- [NR3C1](https://trialight.com/data/target/nr3c1-98974b8d-fb89-5483-955e-d4a994c71532.md)

---

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