In INPULSIS-@ , there was no significant difference between the nintedanib and placebo groups in the time to the first acute exacerbation ( hazard ratio with nintedanib , @ ; @ % CI , @ to @ ; P = @ ) ; in INPULSIS-@ , there was a significant benefit with nintedanib versus placebo ( hazard ratio , @ ; @ % CI , @ to @ ; P = @ ) .