title: Efficacy and safety of fluticasone furoate/vilanterol (50/25 mcg; 100/25 mcg; 200/25 mcg) in Asian patients with chronic obstructive pulmonary disease: a randomized placebo-controlled trial.
abstract: OBJECTIVE
  Three strengths of fluticasone furoate/vilanterol (FF/VI) were previously evaluated for the treatment of chronic obstructive pulmonary disease (COPD) in a program of global Phase 3 studies that included only a small subgroup of Asian patients. This study further evaluated the efficacy and safety of the same three strengths of FF/VI exclusively in Asian patients.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Patients with post-bronchodilator FEV1/FVC ≤0.70, FEV1 ≤70% predicted and modified Medical Research Council score ≥2 were randomized (1:1:1:1) to placebo, FF/VI 50/25 mcg, 100/25 mcg or 200/25 mcg once daily via the ELLIPTA dry powder inhaler. The primary efficacy endpoint was change from baseline in trough FEV1 at Week 24.
  
  
  RESULTS
  The intent-to-treat population comprised 643 patients. Statistically significant (p < 0.001) improvements in trough FEV1 were observed with all strengths of FF/VI versus placebo at Week 24 (0.14-0.19 L). Reduction of supplemental albuterol use was observed with all strengths of FF/VI versus placebo. The incidence of on-treatment adverse events (AEs) was 48% with FF/VI 200/25 mcg and 37-40% with other treatments. The incidence of on-treatment serious AEs was 4-9% with FF/VI treatments versus 9% with placebo; however, the study only covered a 6 month treatment period and was not powered to assess effects on exacerbations. No clinically significant treatment effects versus placebo were identified for electrocardiogram, vital signs, 24 hour urinary cortisol excretion and pneumonia.
  
  
  CONCLUSIONS
  All strengths of FF/VI improved lung function with an acceptable safety profile. There is no evidence to suggest that dose adjustment may be required in Asian patients using FF/VI 100/25 mcg for the treatment of COPD.
  
  
  BACKGROUND
  NCT01376245.
authors.affiliation: State Key Lab of Respiratory Disease, National Clinical Research Centre of Respiratory Disease, 1st Affiliated Hospital of Guangzhou Medical University , Guangzhou , China.
authors.forename: Jinping
authors.initials: J
authors.lastname: Zheng
authors.forename: Teresita
authors.initials: T
authors.lastname: de Guia
authors.forename: Jie
authors.initials: J
authors.lastname: Wang-Jairaj
authors.forename: Amy H
authors.initials: AH
authors.lastname: Newlands
authors.forename: Changzheng
authors.initials: C
authors.lastname: Wang
authors.forename: Courtney
authors.initials: C
authors.lastname: Crim
authors.forename: Nanshan
authors.initials: N
authors.lastname: Zhong
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000420:Albuterol / Q000627:therapeutic use; D000730:Androstadienes / Q000008:administration & dosage* / Q000009:adverse effects; D044466:Asian People; D001592:Benzyl Alcohols / Q000008:administration & dosage* / Q000009:adverse effects; D002722:Chlorobenzenes / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D058995:Dry Powder Inhalers; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000730:Androstadienes; D001592:Benzyl Alcohols; D002722:Chlorobenzenes; D004338:Drug Combinations; D005938:Glucocorticoids; C550468:vilanterol; C523187:fluticasone furoate; D000420:Albuterol; D006854:Hydrocortisone
keywords: Bronchodilator agents; COPD; Clinical respiratory medicine; Clinical trials; Respiratory function test