A Randomized, Double Blind, Placebo Controlled, Incomplete Block, Crossover, Dose Ranging Study to Evaluate the Dose Response of GSK573719 Administered Once or Twice Daily Over 7 Days in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Inhaled bronchodilators, such as beta 2 agonists and anticholinergics, and inhaled
corticosteroids are the mainstays of therapy in patients diagnosed with COPD. Anticholinergic
bronchodilators or long acting muscarinic receptor antagonists function by blocking
endogenous airway smooth muscle cholinergic tone. Treatment with anticholinergics has been
shown to significantly improve forced expiratory volume in 1 second (FEV1), resting and
dynamic lung hyperinflation, symptoms, and exercise capacity in patients with COPD. Currently
tiotropium is the only approved long acting muscarinic antagonist available for treatment of
COPD.

This is a multicenter, randomized, double-blind, placebo controlled, three way crossover,
incomplete block study to evaluate 4 doses of GSK573719 inhaled once daily and 2 doses of
GSK573719 inhaled twice daily over 7 days in patients with COPD. Tiotropium will be included
as an open label active comparator. A placebo treatment will be included to evaluate
treatment effect of each GSK573719 dose. Pharmacokinetic profiles of GSK573719 will also be
determined. Each eligible subject will receive a sequence of 3 of 8 potential treatments for
a total of 3 treatment periods per subject. There will be 7 clinic visits, during three of
which 24 hour serial spirometry will be performed. The total duration of subject
participation is approximately 9 weeks.

Inclusion Criteria:

- Outpatient

- A signed and dated written informed consent prior to study participation.

- Male or female adults.

- 40 to 80 years of age at Visit 1

- Diagnosis of COPD

- Current or former cigarette smokers with a history of cigarette smoking of greater
than or equal to 10 pack-years

- Post-albuterol forced expiratory volume in 1 second (FEV1)/ forced vital capacity
(FVC)<0.70 and post albuterol FEV1 of greater than or equal to 35% and less than or
equal to 70% of predicted normal values

Exclusion Criteria:

- Women who are pregnant or lactating or are planning on becoming pregnant during the
study.

- A current diagnosis of asthma

- Known alpha-1 antitrypsin deficiency, active lung infections (such as tuberculosis),
and lung cancer

- Other significant respiratory conditions in addition to COPD

- Other diseases that are uncontrolled including cancer in remission for less than 5
years

- Chest x-ray or CT scan with clinically significant abnormalities not believed to be
due to the presence of COPD

- Hypersensitivity to any anticholinergic/muscarinic receptor antagonist, beta2-agonist,
lactose/milk protein or magnesium stearate

- A medical condition that contraindicates study participation or use of an inhaled
anticholinergic

- Hospitalization for COPD or pneumonia within 12 weeks of Visit 1

- Any previous lung resection surgery

- A body mass index (BMI) value of >35 kilogram (kg)/meter squared (m2)

- An abnormal and significant electrocardiogram finding at Visit 1

- Significantly abnormal finding from clinical chemistry or haematology tests at Visit
1.

- A positive Hepatitis B surface antigen or positive Hepatitis C antibody

- Medically unable to withhold albuterol (salbutamol) for the 6 hour period prior to
study visits

- Use of depot corticosteroids within 12 weeks of Visit 1

- Use of oral or parenteral corticosteroids or antibiotics for lower respiratory tract
infection within 6 weeks of Visit 1

- Use of long-acting beta-agonist (LABA)/inhaled corticosteroid (ICS) product if
LABA/ICS therapy is discontinued within 30 days of Visit 1

- Use of ICS at a dose of >1000mcg/day of fluticasone propionate or equivalent within 30
days of Visit 1

- Initiation or discontinuation of ICS within 30 days of Visit 1

- Use of tiotropium or phosphodiesterase 4 inhibitors within 14 days of Visit 1

- Use of theophyllines, oral leukotriene inhibitors, long-acting oral beta-agonists, or
inhaled long-acting beta-agonists within 48 hours of Visit 1

- Short-acting oral beta-agonists within 12 hours of Visit 1

- Use of LABA/ICS combination products only if discontinuing LABA therapy and switching
to ICS monotherapy within 48 hours of Visit 1 for the LABA component

- Use of sodium cromoglycate or nedocromil sodium within 24 hours of Visit 1

- Use of inhaled short-acting beta-agonists, inhaled short-acting anticholinergics, or
inhaled short-acting anticholinergic/short-acting beta-agonist combination products
within 6 hours of Visit 1

- Use of any other investigational medication within 30 days or 5 drug half-lives
(whichever is longer)

- Oxygen therapy prescribed for greater than 12 hours a day

- Regular use (prescribed for use every day, not for as-needed use) of short-acting
bronchodilators

- Use of continuous positive airway pressure (CPAP), nocturnal positive pressure or
non-invasive positive pressure ventilation (NIPPV), including use for sleep apnea.

- Acute phase of a pulmonary rehabilitation program within 4 weeks prior to Visit 1

- A known or suspected history of alcohol or drug abuse within 2 years prior to Visit 1

- Anyone affiliated with investigator site

- Previous use of GSK573719 or GSK53719/GW642444