The effect of fluticasone furoate/umeclidinium in adult patients with asthma: A randomized, dose-ranging study
We evaluated the doseeresponse of umeclidinium (UMEC; a long-acting muscarinic antagonist) combined with fluticasone furoate (FF; an inhaled corticosteroid [ICS]) in patients with asthma. Methods: In a double-blind, three-period crossover study, 421 subjects (symptomatic on ICS), were randomized to a sequence of three of seven treatments: FF 100 mcg alone, FF 100 mcg combined with UMEC (15.6, 31.25, 62.5, 125, or 250 mcg), or vilanterol 25 mcg (a long-acting b-agonist), inhaled once-daily for
... ed once-daily for 14 days (12e14-day washout). Trough forced expiratory volume in one second (FEV 1 ), peak expiratory flow (PEF), and safety were assessed. Results: Period baseline was a significant covariate, indicating a potential carryover effect between treatment periods. Across all treatment periods, trough FEV 1 improved with FF/UMEC 125 and 250 versus FF (treatment difference 0.055 L [both doses]; p Z 0.018). FF/UMEC increased morning (15.9e22.9 L/min) and evening (16.2e28.8 L/min) PEF versus FF. As intended assessments were confounded, post hoc Period 1 data analyses were performed, demonstrating significant increases in trough FEV 1 with FF/UMEC 31.25, 62.5, and 250 versus FF. Trough FEV 1 improvements with FF/UMEC were greater in subjects with fixed (0.095 e0.304 L) versus non-fixed (À0.084 to 0.041 L) obstruction. The incidence of on-treatment adverse events was 13e25% across groups. No treatment-related effects on laboratory parameters were reported.