In INPULSIS-1 , there was no significant difference between the nintedanib and placebo groups in the time to the first acute exacerbation ( hazard ratio with nintedanib , 1.15 ; 95 % CI , 0.54 to 2.42 ; P = 0.67 ) ; in INPULSIS-2 , there was a significant benefit with nintedanib versus placebo ( hazard ratio , 0.38 ; 95 % CI , 0.19 to 0.77 ; P = 0.005 ) .