About this trial
Several studies have demonstrated the benefits of the LAMA (Long-Acting Muscarinic Antagonists) + LABA (Long-Acting Beta-Agonists) + IC (inhaled corticosteroids) combination in the treatment of chronic obstructive pulmonary disease (COPD). The use of the triple combination in patients with severe airflow obstruction and a history of flares has been associated with improved lung function, improved patient-reported endpoints and prevention of flares, when compared to LABA, LABA + LAMA and LABA + IC. Furthermore, when compared to dual therapies LABA + IC and LABA + LAMA, triple therapy has been able to reduce all-cause deaths among chronic obstructive pulmonary disease (COPD) patients.
Previously published studies have demonstrated that the triple combination of Fluticasone 250 mcg/Formoterol 12 mcg/Glycopyrronium 12.5 mcg was able to improve lung function in chronic obstructive pulmonary disease (COPD) patients with a history of flares. There was also a significant improvement in the mMRC (modified-Medical Research Council) which began in the 2nd week of treatment and continued up to week 12. The association was considered safe and well tolerated, with only mild to moderate adverse events recorded in approximately 25% of the subjects treated in the study.
Furthermore, bioavailability studies performed with the components of the combination proposed as experimental drug - Fluticasone/Formoterol/Glycopyrronium - indicated that there is no pharmacokinetic interaction between the 3 active ingredients when they were administered concomitantly to healthy individuals under fasting conditions.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Signed Informed Consent Form (ICF).
Male or female aged 40 or over.
Medical diagnosis of chronic obstructive pulmonary disease (COPD) documented by post-bronchodilator FEV1/FVC (Forced Expiratory Volume in the 1st second/ Forced Vital Capacity) ratio < 0.7 (Previous examination report or examination performed at the screening visit).
Disqualifiers
Pregnant or lactating women.
Current diagnosis of asthma without current diagnosis of chronic obstructive pulmonary disease (COPD). Observation: Subjects with a prior history of asthma are eligible if they have a current diagnosis of chronic obstructive pulmonary disease (COPD).
Other respiratory disorders other than chronic obstructive pulmonary disease (COPD) (for example, but not restricted to: active tuberculosis, sarcoidosis, pulmonary fibrosis, pulmonary hypertension).
Trial design
Parallel
Treatments tested in this trial
Fluticasone 250mcg/Formoterol 12mcg/Glycopyrronium 25mcg
DrugParticipants randomized to this group will receive 1 capsule per inhalation twice a day
Comparator - Trimbow®
DrugParticipants randomized to this group will receive 2 triggering twice a day
Treatment groups
Trial outcomes
Primary outcomes
Change to morning pre-dose FEV1
Change to morning pre-dose FEV1 at week 12 relative to baseline Forced expiratory volume in the first (FEV1).
Secondary outcomes
Change to SGRQ (Saint George's Respiratory Questionnaire)
Change to SGRQ (Saint George's Respiratory Questionnaire) total score at week 12 compared to baseline
Change to the COPD (chronic obstructive pulmonary disease )
Change to the COPD (chronic obstructive pulmonary disease ) Assessment Test (CAT - questionnaire to measure the impact of COPD on a person's life) in weeks 4 and 12 in relation to baseline
Sponsors and contacts
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