ERJ Open Research | 2021

Lung function improvements following inhaled indacaterol/glycopyrronium/mometasone furoate are independent of dosing time in asthma patients: a randomised trial

 
 
 
 
 
 
 
 

Abstract


Once-daily asthma treatment should prevent night-time deterioration, irrespective of the time of dosing. IND/GLY/MF, a fixed-dose combination of inhaled indacaterol acetate (IND, long-acting β2-agonist (LABA)), glycopyrronium bromide (GLY, long-acting muscarinic antagonist) and mometasone furoate (MF, inhaled corticosteroid (ICS)) delivered by Breezhaler, is indicated in adult asthma patients inadequately controlled on LABA/ICS. A randomised, double-blind, placebo-controlled, three-period, crossover, phase II study was performed to investigate the bronchodilator effect of IND/GLY/MF (150/50/80\u2005μg) dosed morning and evening versus placebo in patients with mild-moderate asthma. The primary end-point was weighted mean forced expiratory volume in 1\u2005s (FEV1) over 24\u2005h following 14\u2005days of IND/GLY/MF dosed a.m. and p.m. versus placebo. Secondary end-points included the effect of dosing time on peak expiratory flow (PEF) and safety/tolerability. Of 37 randomised patients (age 18–72\u2005years; 21 male, 16 female) 34 completed all three treatment periods. At screening, median (range) pre-bronchodilator FEV1 was 75.8% (60–96%). Patients were using stable low- (83.8%) or medium-dose (16.2%) ICS. Morning and evening dosing of IND/GLY/MF improved FEV1 (area under the curve from 0 to 24\u2005h) by 610\u2005mL (90% CI 538–681 mL) and 615\u2005mL (90% CI 544–687 mL), respectively, versus placebo. Mean PEF over 14\u2005days increased by 70.7\u2005L·min−1 (90% CI 60.5–80.9 L·min−1) following a.m. dosing, and by 59.7\u2005L·min−1 (90% CI 49.5–69.9\u2005L·min−1) following p.m. dosing of IND/GLY/MF versus placebo. IND/GLY/MF demonstrated a safety profile comparable with placebo. Once-daily inhaled IND/GLY/MF was well tolerated and provided sustained lung function improvements over 24\u2005h, irrespective of a.m. or p.m. dosing, in patients with mild–moderate asthma. This randomised study found single-inhaler indacaterol/glycopyrronium/mometasone furoate improved respiratory parameters FEV1 and PEF in asthma patients, and showed similar efficacy when taken once daily in the morning or evening https://bit.ly/3fH0I1K

Volume 7
Pages None
DOI 10.1183/23120541.00425-2020
Language English
Journal ERJ Open Research

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