The Efficacy and Safety of Once-daily Fluticasone Furoate/Umeclidinium/Vilanterol Versus Twice-daily Budesonide/Formoterol in a Subgroup of Patients from China with Symptomatic COPD at Risk of Exacerbations (FULFIL Trial)

COPD. 2018 Jun-Aug;15(4):334-340. doi: 10.1080/15412555.2018.1481022. Epub 2018 Sep 28.

Abstract

The FULFIL study evaluated once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100 µg/62.5 µg/25 µg versus twice-daily budesonide/formoterol (BUD/FOR) 400 µg/12 µg in patients with symptomatic COPD at risk of exacerbations. FULFIL demonstrated clinically meaningful and statistically significant improvements at Week 24 in trough forced expiratory volume in 1 second (FEV1), St George's Respiratory Questionnaire (SGRQ) Total scores and reduced exacerbation frequency. Predefined analyses were performed to evaluate treatment effects in a subgroup of patients recruited in China (China subgroup; FF/UMEC/VI, n = 32; BUD/FOR, n = 29). Analyses included treatment by region (China versus non-China) to allow estimated treatment effects in patients from China to be compared with those of the non-China subgroup and the overall FULFIL intent-to-treat (ITT) population. In the China subgroup at Week 24: the mean change from baseline in trough FEV1 was 125 mL (95% confidence interval [CI] 36, 214) for FF/UMEC/VI and -70 mL (95% CI -163, 23) BUD/FOR (between-treatment difference: 195 mL [95% CI 67, 323]; p = 0.003) and in SGRQ Total score was -5.6 units (95% CI -10.5, -0.7) and -0.3 units (95% CI -5.4, 4.7), respectively (between-treatment difference: -5.3 [95% CI -12.3, 1.7]; p = 0.140). Fewer moderate/severe exacerbations occurred with FF/UMEC/VI than BUD/FOR (16% and 28%, respectively). The overall incidence of adverse events was similar between arms (FF/UMEC/VI: 38%; BUD/FOR: 31%). This prespecified subgroup analysis of patients recruited in China to FULFIL demonstrated comparable efficacy and safety to that observed in the non-China and in the overall ITT populations, for FF/UMEC/VI versus BUD/FOR.

Keywords: China; GSK study CTT116853; NCT02345161; health-related quality of life; lung function; single inhaler triple therapy.

Publication types

  • Clinical Trial, Phase III
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Androstadienes / therapeutic use*
  • Benzyl Alcohols / therapeutic use*
  • Bronchodilator Agents / therapeutic use*
  • Budesonide, Formoterol Fumarate Drug Combination / therapeutic use*
  • China
  • Chlorobenzenes / therapeutic use*
  • Disease Progression
  • Double-Blind Method
  • Drug Combinations
  • Female
  • Forced Expiratory Volume
  • Glucocorticoids / therapeutic use*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Quality of Life
  • Quinuclidines / therapeutic use*
  • Spirometry
  • Treatment Outcome
  • Vital Capacity

Substances

  • Androstadienes
  • Benzyl Alcohols
  • Bronchodilator Agents
  • Budesonide, Formoterol Fumarate Drug Combination
  • Chlorobenzenes
  • Drug Combinations
  • GSK573719
  • Glucocorticoids
  • Quinuclidines
  • vilanterol
  • fluticasone furoate