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A multicenter, randomized, double-blind dose-ranging study of glycopyrrolate/formoterol fumarate fixed-dose combination metered dose inhaler compared to the monocomponents and open-label tiotropium dry powder inhaler in patients with moderate-to-severe COPD - 04/11/16

Doi : 10.1016/j.rmed.2016.09.012 
Donald P. Tashkin a, , Fernando J. Martinez b, Roberto Rodriguez-Roisin c, Charles Fogarty d, Mark Gotfried e, Michael Denenberg f, Gregory Gottschlich g, James F. Donohue h, Chad Orevillo i, Patrick Darken i, Earl St Rose i, Shannon Strom j, Tracy Fischer j, Michael Golden j, Colin Reisner i
a David Geffen School of Medicine at UCLA, Los Angeles, CA, USA 
b Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College, New York, NY, USA 
c Servei de Pneumologia, Institut del Tòrax, Hospital Clínic-IDIBAPS-CIBERES, University of Barcelona, Barcelona, Spain 
d Spartanburg Medical Research, Spartanburg, SC, USA 
e Pulmonary Associates, Phoenix, AZ, USA 
f Clinical Research of Rock Hill, Rock Hill, SC, USA 
g New Horizons Clinical Research, Cincinnati, OH, USA 
h University of North Carolina School of Medicine, Chapel Hill, NC, USA 
i Pearl Therapeutics Inc., Morristown, NJ, USA 
j Pearl Therapeutics Inc., Durham, NC, USA 

Corresponding author.

Abstract

Background

This study formed part of the dose selection for a glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination formulated using novel Co-Suspension™ Delivery Technology and delivered via a metered dose inhaler (GFF MDI). The study aimed to confirm the optimal dose of GP to formulate with FF 9.6 μg in the fixed-dose combination product, GFF MDI.

Methods

This multicenter, randomized, double-blind, chronic-dosing, balanced incomplete block, crossover study (NCT01587079) compared five doses of GFF MDI (18/9.6, 9/9.6, 4.6/9.6, 2.4/9.6 and 1.2/9.6 μg, twice daily [BID]) with its monocomponents FF MDI 9.6 μg and GP MDI 18 μg (both BID) and open-label tiotropium (18 μg once daily) as the active control. The primary efficacy endpoint was change from baseline in forced expiratory volume in 1 s area under the curve from 0 to 12 h (FEV1 AUC0–12) on Day 7.

Results

In total, 159 patients were randomized to treatment and 132 patients (52.2% male, mean age 62.8 years) were included in the intent-to-treat population. All doses of GFF MDI (except 1.2/9.6 μg) resulted in statistically significant improvements in FEV1 AUC0–12 versus monocomponents and open-label tiotropium. GFF MDI 18/9.6 μg consistently showing the greatest improvement over monocomponents and open-label tiotropium. Adverse events for each GFF MDI dose were similar versus GP MDI 18 μg, FF MDI 9.6 μg and open-label tiotropium.

Conclusions

These findings further support selection of GP 18 μg as the optimal dose to combine with FF MDI 9.6 μg for advancement into Phase III clinical trials of GFF MDI.

Le texte complet de cet article est disponible en PDF.

Highlights

Of the dose-range evaluated, GFF MDI 18/9.6 μg was the most effective at improving lung function.
GFF MDI 18/9.6 μg significantly improved FEV1 AUC0−12 vs GP MDI 18 μg, FF MDI 9.6 μg and open-label tiotropium.
All doses of GFF MDI (except 1.2/9.6 μg) significantly improved FEV1 AUC0–12 vs comparators, in a dose-ordered manner.
Adverse event profiles were similar across all treatment groups.
GP 18 μg was determined as the optimal dose to combine with FF MDI 9.6 μg for Phase III trials.

Le texte complet de cet article est disponible en PDF.

Keywords : Bronchodilators, Fixed-dose combinations, LAMA, LABA, Co-Suspension™ Delivery Technology, COPD maintenance therapy


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© 2016  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 120

P. 16-24 - novembre 2016 Retour au numéro
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