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Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies.
Respir Med 2015; 109(9):1155-63RM

Abstract

OBJECTIVE

The aim of these studies (NCT01957163; NCT02119286) was to evaluate the efficacy and safety of umeclidinium (UMEC 62.5 μg and 125 μg) added to fluticasone furoate/vilanterol (FF/VI, 100/25 μg) in chronic obstructive pulmonary disease (COPD).

METHODS

These were 12-week, double-blind, placebo-controlled, parallel-group, multicenter studies. Eligible patients were randomized 1:1:1 to treatment with once-daily blinded UMEC 62.5 μg (delivering 55 μg), UMEC 125 μg (delivering 113 μg) or placebo (PBO) added to open-label FF/VI (delivering 92/22 μg; N = 1238 [intent-to-treat population]). The primary endpoint was trough forced expiratory volume in one second (FEV1) on Day 85; the secondary endpoint was 0-6 h post-dose weighted mean (WM) FEV1 at Day 84. Health-related quality of life was reported using St George's respiratory questionnaire (SGRQ). Adverse events (AEs) were also assessed.

RESULTS

In both studies, trough FEV1 was significantly improved with UMEC + FF/VI (62.5 μg and 125 μg) versus PBO + FF/VI (range: 0.111-0.128 L, all p < 0.001 [Day 85]), as was 0-6 h post-dose WM FEV1 (range: 0.135-0.153 L, all p < 0.001 [Day 84]). SGRQ results were inconsistent, with statistically significant improvements with UMEC + FF/VI versus PBO + FF/VI in one study only and with UMEC 62.5 μg only (difference in SGRQ total score from baseline between treatments: -2.16, p < 0.05). Across all treatment groups, the overall incidences of AEs were similar (30-39%), as were cardiovascular AEs of special interest (<1-3%) and pneumonia AEs (0-1%).

CONCLUSION

Overall, the addition of UMEC to FF/VI therapy resulted in significant improvements in lung function compared with PBO + FF/VI in patients with COPD, with similar safety profiles, though SGRQ results were inconsistent.

CLINICAL RELEVANCE

The results from these two studies demonstrate that the addition of umeclidinium (62.5 μg and 125 μg) to FF/VI (100/25 μg) provides statistically significant and clinically meaningful improvements in lung function compared with placebo + FF/VI in patients with COPD. Statistically significant improvements in quality of life with UMEC + FF/VI versus placebo + FF/VI were reported in one study only. Safety profiles were consistent across all treatment groups in both studies. These studies support the use of triple therapy in COPD, providing physicians with an alternative treatment option.

Authors+Show Affiliations

Midwest Chest Consultants, PC, 330 First Capitol Drive, Suite 470, St Charles, MO, USA. Electronic address: thomas.siler.md@midwestchest.com.Clinical Research Institute of Southern Oregon, Medford, OR, USA.GSK, Respiratory Medicines Development Centre, Stockley Park, Middlesex, UK.GSK, Respiratory and Immuno-Inflammation, Research Triangle Park, NC, USA.GSK, Respiratory Medicines Development Centre, Stockley Park, Middlesex, UK.GSK, Respiratory and Immuno-Inflammation, Research Triangle Park, NC, USA.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26117292

Citation

Siler, Thomas M., et al. "Efficacy and Safety of Umeclidinium Added to Fluticasone Furoate/vilanterol in Chronic Obstructive Pulmonary Disease: Results of Two Randomized Studies." Respiratory Medicine, vol. 109, no. 9, 2015, pp. 1155-63.
Siler TM, Kerwin E, Sousa AR, et al. Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies. Respir Med. 2015;109(9):1155-63.
Siler, T. M., Kerwin, E., Sousa, A. R., Donald, A., Ali, R., & Church, A. (2015). Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies. Respiratory Medicine, 109(9), pp. 1155-63. doi:10.1016/j.rmed.2015.06.006.
Siler TM, et al. Efficacy and Safety of Umeclidinium Added to Fluticasone Furoate/vilanterol in Chronic Obstructive Pulmonary Disease: Results of Two Randomized Studies. Respir Med. 2015;109(9):1155-63. PubMed PMID: 26117292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies. AU - Siler,Thomas M, AU - Kerwin,Edward, AU - Sousa,Ana R, AU - Donald,Alison, AU - Ali,Rehan, AU - Church,Alison, Y1 - 2015/06/14/ PY - 2015/02/18/received PY - 2015/06/02/revised PY - 2015/06/10/accepted PY - 2015/6/29/entrez PY - 2015/6/29/pubmed PY - 2016/6/2/medline KW - Bronchodilation KW - Inhaled corticosteroid KW - Long-acting beta(2) agonist KW - Long-acting muscarinic antagonist SP - 1155 EP - 63 JF - Respiratory medicine JO - Respir Med VL - 109 IS - 9 N2 - OBJECTIVE: The aim of these studies (NCT01957163; NCT02119286) was to evaluate the efficacy and safety of umeclidinium (UMEC 62.5 μg and 125 μg) added to fluticasone furoate/vilanterol (FF/VI, 100/25 μg) in chronic obstructive pulmonary disease (COPD). METHODS: These were 12-week, double-blind, placebo-controlled, parallel-group, multicenter studies. Eligible patients were randomized 1:1:1 to treatment with once-daily blinded UMEC 62.5 μg (delivering 55 μg), UMEC 125 μg (delivering 113 μg) or placebo (PBO) added to open-label FF/VI (delivering 92/22 μg; N = 1238 [intent-to-treat population]). The primary endpoint was trough forced expiratory volume in one second (FEV1) on Day 85; the secondary endpoint was 0-6 h post-dose weighted mean (WM) FEV1 at Day 84. Health-related quality of life was reported using St George's respiratory questionnaire (SGRQ). Adverse events (AEs) were also assessed. RESULTS: In both studies, trough FEV1 was significantly improved with UMEC + FF/VI (62.5 μg and 125 μg) versus PBO + FF/VI (range: 0.111-0.128 L, all p < 0.001 [Day 85]), as was 0-6 h post-dose WM FEV1 (range: 0.135-0.153 L, all p < 0.001 [Day 84]). SGRQ results were inconsistent, with statistically significant improvements with UMEC + FF/VI versus PBO + FF/VI in one study only and with UMEC 62.5 μg only (difference in SGRQ total score from baseline between treatments: -2.16, p < 0.05). Across all treatment groups, the overall incidences of AEs were similar (30-39%), as were cardiovascular AEs of special interest (<1-3%) and pneumonia AEs (0-1%). CONCLUSION: Overall, the addition of UMEC to FF/VI therapy resulted in significant improvements in lung function compared with PBO + FF/VI in patients with COPD, with similar safety profiles, though SGRQ results were inconsistent. CLINICAL RELEVANCE: The results from these two studies demonstrate that the addition of umeclidinium (62.5 μg and 125 μg) to FF/VI (100/25 μg) provides statistically significant and clinically meaningful improvements in lung function compared with placebo + FF/VI in patients with COPD. Statistically significant improvements in quality of life with UMEC + FF/VI versus placebo + FF/VI were reported in one study only. Safety profiles were consistent across all treatment groups in both studies. These studies support the use of triple therapy in COPD, providing physicians with an alternative treatment option. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/26117292/Efficacy_and_safety_of_umeclidinium_added_to_fluticasone_furoate/vilanterol_in_chronic_obstructive_pulmonary_disease:_Results_of_two_randomized_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(15)30009-3 DB - PRIME DP - Unbound Medicine ER -