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Efficacy and Safety of Once-Daily Inhaled Umeclidinium in Asian Patients with COPD: Results from a Randomized, Placebo-Controlled Study

Authors Zhong N, Zheng J, Lee SH, Lipson DA, Du X, Wu S

Received 8 May 2019

Accepted for publication 10 January 2020

Published 17 April 2020 Volume 2020:15 Pages 809—819


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Chunxue Bai

Nanshan Zhong,1 Jinping Zheng,1 Sang Haak Lee,2 David A Lipson,3 Xin Du,4 Shunquan Wu4

1State Key Laboratory of Respiratory Disease, National Clinical Research Centre of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China; 2Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea; 3GSK, Collegeville, and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 4GSK, Shanghai, People’s Republic of China

Correspondence: Jinping Zheng Email

Purpose: Previous studies demonstrating efficacy and safety of once-daily umeclidinium (UMEC) in patients with chronic obstructive pulmonary disease (COPD) have included few Asian patients. This study evaluated efficacy and safety of UMEC 62.5 mcg versus placebo in Asian patients with COPD.
Patients and Methods: A Phase III, randomized, double-blind, parallel-group study. Patients (aged ≥ 40 years with COPD, pre-, and post-albuterol forced expiratory volume in 1 s [FEV1]/forced vital capacity ratio < 0.70 and low risk of exacerbations) were randomized 2:1 to once-daily UMEC 62.5 mcg or placebo via the ELLIPTA inhaler for 24 weeks. Primary endpoint was change from baseline (CFB) in trough FEV1 on Day 169. Secondary endpoints were weighted mean FEV1 over 0– 6 hrs post-dose on Day 1 and CFB in Transition Dyspnea Index (TDI) focal score on Day 168.
Results: A total of 306 patients were included in the modified intent-to-treat population (UMEC: 205; placebo: 101). UMEC versus placebo provided a statistically significant improvement in least squares (LS) mean trough FEV1 between baseline and Day 169 (154 mL [95% confidence interval (CI): 113, 194]; p< 0.001). A clinically meaningful difference of 125 mL in favor of UMEC (95% CI: 103, 147; p< 0.001) was also seen in LS weighted mean FEV1 0– 6 hrs post-dose on Day 1. A LS mean treatment difference in TDI focal score of 0.9 units in favor of UMEC was seen on Day 168 (95% CI: 0.3, 1.5; p=0.004). Incidence of on-treatment adverse events (AEs) was lower in the placebo (55%) versus UMEC arm (60%); non-fatal serious AEs, drug-related AEs, and AEs leading to withdrawal were similar with UMEC and placebo.
Conclusion: Once-daily UMEC 62.5 mcg resulted in statistically significant and clinically meaningful improvements in lung function and dyspnea, compared with placebo, in Asian patients with COPD, with no new safety concerns observed.

Keywords: Asia, chronic obstructive pulmonary disease, forced expiratory volume in 1 second, Transition Dyspnea Index, umeclidinium

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