| 1. |
- Bleecker, E. R., et al.
(författare)
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Once-daily fluticasone furoate is efficacious in patients with symptomatic asthma on low-dose inhaled corticosteroids
- 2012
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Ingår i: Annals of Allergy Asthma & Immunology. - : Elsevier BV. - 1081-1206. ; 109:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fluticasone furoate (FF) is an inhaled corticosteroid (ICS) with 24-hour activity in development as a once-daily treatment for the long-term management of asthma. Objective: To assess the efficacy and safety of 4 doses of once-daily FF administered using a dry powder inhaler in patients (>12 years) with moderate asthma, uncontrolled on low-dose ICS (fluticasone propionate [FP] 200 mu g/day or equivalent). Methods: This double-blind, placebo-controlled, dose-ranging study randomized 622 patients to 1 of 6 treatments: FF (100, 200, 300, or 400 mu g) once daily in the evening, FP 250 mu g twice daily (active control), or placebo for 8 weeks. The primary endpoint was the change from baseline in predose evening forced expiratory colume in 1 second (FEV1) at week 8. Results: At week 8, relative to placebo, all doses of FF once daily and FP twice daily demonstrated significantly (P < .001) greater increases from baseline and greater than 200-mL increases in predose FEV1. There was no evidence of a dose-response relationship between FF doses. Improvement with once-daily FF was similar to or greater than that for twice-daily FP. Secondary efficacy endpoint findings generally supported the efficacy of FF 100 to 400 mu g once daily, although statistically significant improvements versus placebo in symptom-free 24-hour periods were only reported for FF 400 mu g. There were few withdrawals due to lack of efficacy. Oral candidiasis was reported in 0 to 4% of patients; 24-hour urinary cortisol excretion ratios were similar across active treatment groups and not significantly different from placebo. Conclusion: FF 100 to 400 mu g once daily in the evening is effective and well tolerated in patients with asthma uncontrolled on low-dose ICS, with 100 mu g and 200 mu g, considered the most applicable doses in this asthma population. Trial Registration: clinicaltrials.gov Identifier: NCT00603278. (C) 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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| 2. |
- Busse, WW, et al.
(författare)
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Fluticasone furoate demonstrates efficacy in patients with asthma symptomatic on medium doses of inhaled corticosteroid therapy: an 8-week, randomised, placebo-controlled trial
- 2012
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Ingår i: Thorax. - : BMJ. - 0040-6376 .- 1468-3296. ; 67:1, s. 35-41
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Fluticasone furoate (FF) is a novel inhaled corticosteroid with 24 h activity. FF is being developed as a once-daily treatment in combination with the long-acting β(2) agonist vilanterol trifenatate for asthma and chronic obstructive pulmonary disease. Objectives To determine the optimal dose(s) of FF for treating patients with asthma. Methods An 8-week multicentre, randomised, double-blind study. 627 patients with persistent moderate-to-severe asthma, symptomatic on medium-dose inhaled corticosteroid therapy, were randomised to placebo, FF 200, 400, 600 or 800 μg (once daily in the evening using a novel dry powder inhaler), or fluticasone propionate 500 μg twice daily (via Diskus™/Accuhaler™). The primary efficacy measure was mean change from baseline in pre-dose evening forced expiratory volume in one second (FEV(1)). Other endpoints included morning and evening peak expiratory flow, and rescue/symptom-free 24 h periods. Results Each dose was significantly superior to placebo for the primary endpoint (p<0.001) with efficacy at least similar to that reported with fluticasone propionate. There was no dose-response relationship across the FF doses studied. Peak expiratory flow improved in all groups (p<0.001 vs placebo), and there were significant treatment effects on rescue/symptom-free 24 h periods with all active treatments. FF was generally well tolerated. The incidence of oral candidiasis was higher with FF 800 μg than placebo; pharmacokinetic and 24 h urinary cortisol analyses confirmed a higher systemic exposure of FF at this highest dose level. Conclusions FF doses <800 μg have a favourable therapeutic index. The absence of an efficacy dose response suggests that 200 μg is an appropriate dose in patients with moderate persistent asthma. ClinicalTrials.gov identifier NCT00603746
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| 3. |
- Lötvall, Jan, 1956, et al.
(författare)
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24-h duration of the novel LABA vilanterol trifenatate in asthma patients treated with inhaled corticosteroids
- 2012
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 40:3, s. 570-579
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Tidskriftsartikel (refereegranskat)abstract
- Current guidelines recommend adding a long-acting inhaled beta(2)-agonist (LABA) to inhaled corticosteroids (ICS) in patients with uncontrolled asthma. This study evaluated the novel, once-daily LABA vilanterol trifenatate (VI) in asthma patients who remained symptomatic despite existing ICS therapy. The study involved a randomised, double-blind, placebo-controlled trial of VI (3, 6.25, 12.5, 25 and 50 mu g), administered once daily in the evening by dry powder inhaler for 28 days, in asthma patients aged >= 12 yrs symptomatic on current ICS therapy. The primary end-point was trough (24 h post-dose) forced expiratory volume in 1 s (FEV1); secondary end-points were weighted mean FEV1, peak expiratory flow (PEF), symptom-/rescue-free 24-h periods, and safety. A significant relationship was observed between VI dose and improvements in trough FEV1 (p=0.037). Statistically significant increases in mean trough FEV1, relative to placebo, were documented for VI 12.5-50 mu g (121-162 mL; p <= 0.016). Dose-related effects of VI were observed on weighted mean (0-24 h) FEV1, morning/evening PEF, and symptom-/rescue-free 24-h periods. All doses of VI were well tolerated with low incidences of recognised LABA-related adverse events (tremor 0-2%; palpitations 0-2%; glucose effects 0-1%; potassium effects 0-<1%). Once-daily VI 12.5-50 mu g resulted in prolonged bronchodilation of at least 24 h with good tolerability in asthma patients receiving ICS. Based on the overall efficacy and adverse event profile from this study, the optimum dose of VI appears to be 25 mg.
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| 4. |
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| 5. |
- Woodcock, A, et al.
(författare)
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Fluticasone furoate: once-daily evening treatment versus twice-daily treatment in moderate asthma
- 2011
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Ingår i: Respiratory research. - : Springer Science and Business Media LLC. - 1465-9921 .- 1465-993X. ; 12:160
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Inhaled corticosteroids are the recommended first-line treatment for asthma but adherence to therapy is suboptimal. The objectives of this study were to compare the efficacy and safety of once-daily (OD) evening and twice-daily (BD) regimens of the novel inhaled corticosteroid fluticasone furoate (FF) in asthma patients. METHODS: Patients with moderate asthma (age [greater than or equal to]12 years; pre-bronchodilator forced expiratory volume in 1 second (FEV1) 40-85% predicted; FEV1 reversibility of [greater than or equal to]12% and [greater than or equal to]200 ml) were randomized to FF or fluticasone propionate (FP) regimens in a double-blind, crossover study. Patients were inhaled corticosteroid-naive and were not permitted to have used any ICS for [greater than or equal to]8 weeks prior to enrolment and subsequently received doses of FF or FP 200 ug OD, FF or FP 100 ug BD and matching placebo by inhalation for 28 days each. Primary endpoint was Day 28 evening pre-dose (trough) FEV1; non-inferiority of FF 200 ug OD and FF 100 ug BD was assessed, as was superiority of all active treatment relative to placebo. Adverse events (AEs) and 24-hour urinary cortisol excretion were assessed. RESULTS: The intent-to-treat population comprised 147 (FF) and 43 (FP) patients. On Day 28, pre-dose FEV1 showed FF 200 ug OD to be non-inferior (pre-defined limit -110 ml) to FF 100 ug BD (mean treatment difference 11 ml; 95% CI: -35 to +56 ml); all FF and FP regimens were significantly superior to placebo (p [less than or equal to] 0.02). Change from placebo in pre-dose FEV1 with OD FP (87 ml) was numerically lower than BD FP (132 ml). AEs were similar to placebo; no serious AEs were reported. Urinary cortisol excretion at Day 28 for FF was lower than placebo (ratios: 200 ug OD, 0.75; 100 ug BD, 0.84; p [less than or equal to] 0.02). CONCLUSIONS: FF 200 ug OD in the evening is an efficacious and well tolerated treatment for asthma patients and is not inferior to the same total BD dose. Trial registration: Clinicaltrials.gov; NCT00766090
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