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Erschienen in: Clinical Drug Investigation 10/2019

01.10.2019 | Original Research Article

Bronchodilator Efficacy of a Single-Dose 12/400-µg Formoterol/Budesonide Combination as a Dry Powder for Inhalation Delivered by Discair® in Adult Patients with Moderate-to-Severe Stable COPD: Open-Label, Single-Arm, Phase IV Trial

verfasst von: Pinar Yildiz, Mesut Bayraktaroglu, Didem Gorgun, Kivanc Yuksel

Erschienen in: Clinical Drug Investigation | Ausgabe 10/2019

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Abstract

Background and Objectives

A patient-friendly and easy-to-use multi-dose dry powder inhaler, Discair®, has been recently developed. The objective of this study was to evaluate the bronchodilator efficacy of a single-dose 12/400-µg formoterol plus budesonide combination as a dry powder for inhalation delivered by Discair® in adult patients with moderate-to-severe, stable, chronic obstructive pulmonary disease.

Methods

A total of 33 male patients with moderate-to-severe, chronic obstructive pulmonary disease were included in this single-arm, open-label, phase IV trial. The primary efficacy parameters were the average maximum change in forced expiratory volume in 1 s (FEV1, in L) and time to maximum FEV1 response. Absolute and percent change from baseline in FEV1 and forced vital capacity, maximum change and time to peak forced vital capacity response were also evaluated.

Results

The mean post-bronchodilator FEV1 maximum value was significantly higher than the pre-bronchodilator baseline FEV1 value [1.66 (standard deviation 0.43) vs. 1.32 (standard deviation 0.35), p < 0.001], with an absolute change of 0.34 (standard deviation 0.18) and a percent change of 26.0 (standard deviation 0.14) from baseline to maximum response. The average time to peak FEV1 response was 3.94 h (standard deviation 2.75), while the standardized area under the response-time curve from 0 to 12 h for FEV1 was 2.72 (standard deviation 1.84). The FEV1 and forced vital capacity values recorded at each time point during the 12-h post-bronchodilator period were also significantly higher than the baseline values (p < 0.001 for each).

Conclusions

Our findings revealed significant changes from baseline in post-bronchodilator peak and average FEV1 and forced vital capacity responses, indicating bronchodilator efficacy of a single-dose 12/400 µg formoterol plus budesonide dry powder formulation delivered by Discair® in patients with chronic obstructive pulmonary disease.

Trial Registration

ClinicalTrials.gov Identifier NCT03028701.
Literatur
1.
Zurück zum Zitat Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003;21:74–81.CrossRef Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003;21:74–81.CrossRef
2.
Zurück zum Zitat Calverley PM, Eriksson G, Jenkins CR, Anzueto AR, Make BJ, Persson A, et al. Early efficacy of budesonide/formoterol in patients with moderate-to-very-severe COPD. Int J Chron Obstruct Pulmon Dis. 2016;12:13–25.CrossRef Calverley PM, Eriksson G, Jenkins CR, Anzueto AR, Make BJ, Persson A, et al. Early efficacy of budesonide/formoterol in patients with moderate-to-very-severe COPD. Int J Chron Obstruct Pulmon Dis. 2016;12:13–25.CrossRef
3.
Zurück zum Zitat Lewis A, Torvinen S, Dekhuijzen PNR, Chrystyn H, Melani A, Zöllner Y, et al. Budesonide + formoterol delivered via Spiromax® for the management of asthma and COPD: the potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler®. Respir Med. 2017;129:179–88.CrossRef Lewis A, Torvinen S, Dekhuijzen PNR, Chrystyn H, Melani A, Zöllner Y, et al. Budesonide + formoterol delivered via Spiromax® for the management of asthma and COPD: the potential impact on unscheduled healthcare costs of improving inhalation technique compared with Turbuhaler®. Respir Med. 2017;129:179–88.CrossRef
4.
Zurück zum Zitat Perrone V, Sangiorgi D, Buda S, Degli Esposti L. Comparative analysis of budesonide/formoterol and fluticasone/salmeterol combinations in COPD patients: findings from a real-world analysis in an Italian setting. Int J Chron Obstruct Pulmon Dis. 2016;11:2749–55.CrossRef Perrone V, Sangiorgi D, Buda S, Degli Esposti L. Comparative analysis of budesonide/formoterol and fluticasone/salmeterol combinations in COPD patients: findings from a real-world analysis in an Italian setting. Int J Chron Obstruct Pulmon Dis. 2016;11:2749–55.CrossRef
7.
Zurück zum Zitat MAT sales data, Data on file, Teva Pharm. Inc. (Dec 2014). MAT sales data, Data on file, Teva Pharm. Inc. (Dec 2014).
9.
Zurück zum Zitat Cazzola M, Santus P, Di Marco F, Boveri B, Castagna F, Carlucci P, et al. Bronchodilator effect of an inhaled combination therapy with salmeterol + fluticasone and formoterol + budesonide in patients with COPD. Respir Med. 2003;97:453–7.CrossRef Cazzola M, Santus P, Di Marco F, Boveri B, Castagna F, Carlucci P, et al. Bronchodilator effect of an inhaled combination therapy with salmeterol + fluticasone and formoterol + budesonide in patients with COPD. Respir Med. 2003;97:453–7.CrossRef
10.
Zurück zum Zitat Lindberg A, Szalai Z, Pullerits T, Radeczky E. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology. 2007;12:732–9.CrossRef Lindberg A, Szalai Z, Pullerits T, Radeczky E. Fast onset of effect of budesonide/formoterol versus salmeterol/fluticasone and salbutamol in patients with chronic obstructive pulmonary disease and reversible airway obstruction. Respirology. 2007;12:732–9.CrossRef
11.
Zurück zum Zitat Cazzola M, Santus P, Di Marco F, Carlucci P, Mondoni M, Matera MG, et al. Onset of action of formoterol/budesonide in single inhaler vs. formoterol in patients with COPD. Pulm Pharmacol Ther. 2004;17:121–5.CrossRef Cazzola M, Santus P, Di Marco F, Carlucci P, Mondoni M, Matera MG, et al. Onset of action of formoterol/budesonide in single inhaler vs. formoterol in patients with COPD. Pulm Pharmacol Ther. 2004;17:121–5.CrossRef
12.
Zurück zum Zitat Zhong N, Zheng J, Wen F, Yang L, Chen P, Xiu Q, et al. Efficacy and safety of budesonide/formoterol via a dry powder inhaler in Chinese patients with chronic obstructive pulmonary disease. Curr Med Res Opin. 2012;28:257–65.CrossRef Zhong N, Zheng J, Wen F, Yang L, Chen P, Xiu Q, et al. Efficacy and safety of budesonide/formoterol via a dry powder inhaler in Chinese patients with chronic obstructive pulmonary disease. Curr Med Res Opin. 2012;28:257–65.CrossRef
13.
Zurück zum Zitat Ställberg B, Selroos O, Vogelmeier C, Andersson E, Ekström T, Larsson K. Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD A double-blind, randomised, non-inferiority, parallel-group, multicentre study. Respir Res. 2009;10:11.CrossRef Ställberg B, Selroos O, Vogelmeier C, Andersson E, Ekström T, Larsson K. Budesonide/formoterol as effective as prednisolone plus formoterol in acute exacerbations of COPD A double-blind, randomised, non-inferiority, parallel-group, multicentre study. Respir Res. 2009;10:11.CrossRef
14.
Zurück zum Zitat Redelmeier DA, Goldstein RS, Min ST, Hyland RH. Spirometry and dyspnea in patients with COPD. When small differences mean little. Chest. 1996;109:1163–8.CrossRef Redelmeier DA, Goldstein RS, Min ST, Hyland RH. Spirometry and dyspnea in patients with COPD. When small differences mean little. Chest. 1996;109:1163–8.CrossRef
15.
Zurück zum Zitat Partridge MR, Schuermann W, Beckman O, Persson T, Polanowski T. Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis. 2009;3:1–11.CrossRef Partridge MR, Schuermann W, Beckman O, Persson T, Polanowski T. Effect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD. Ther Adv Respir Dis. 2009;3:1–11.CrossRef
16.
Zurück zum Zitat Calverly PMA. The impact of budesonide/formoterol in health status and morning symptoms. Hot Topics Resp Med. 2011;6:17–23. Calverly PMA. The impact of budesonide/formoterol in health status and morning symptoms. Hot Topics Resp Med. 2011;6:17–23.
17.
Zurück zum Zitat Benhamou D, Cuvelier A, Muir JF, Leclerc V, Le Gros V, Kottakis J, et al. Rapid onset of bronchodilation in COPD: a placebo-controlled study comparing formoterol (Foradil Aerolizer) with salbutamol (Ventodisk). Respir Med. 2001;95:817–21.CrossRef Benhamou D, Cuvelier A, Muir JF, Leclerc V, Le Gros V, Kottakis J, et al. Rapid onset of bronchodilation in COPD: a placebo-controlled study comparing formoterol (Foradil Aerolizer) with salbutamol (Ventodisk). Respir Med. 2001;95:817–21.CrossRef
18.
Zurück zum Zitat Cazzola M, Grella E, Matera MG, Mazzarella G, Marsico SA. Onset of action following formoterol Turbuhaler and salbutamol pMDI in reversible chronic airway obstruction. Pulm Pharmacol Ther. 2002;15:97–102.CrossRef Cazzola M, Grella E, Matera MG, Mazzarella G, Marsico SA. Onset of action following formoterol Turbuhaler and salbutamol pMDI in reversible chronic airway obstruction. Pulm Pharmacol Ther. 2002;15:97–102.CrossRef
19.
Zurück zum Zitat Turner J, Wright E, Mendella L, Anthonisen N. Predictors of patient adherence to long-term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent positive pressure breathing. Chest. 1995;108:394–400.CrossRef Turner J, Wright E, Mendella L, Anthonisen N. Predictors of patient adherence to long-term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent positive pressure breathing. Chest. 1995;108:394–400.CrossRef
20.
Zurück zum Zitat Make BJ. Chronic obstructive pulmonary disease: developing comprehensive management. Respir Care. 2003;48:1225–34.PubMed Make BJ. Chronic obstructive pulmonary disease: developing comprehensive management. Respir Care. 2003;48:1225–34.PubMed
21.
Zurück zum Zitat Albert P, Agusti A, Edwards L, Tal-Singer R, Yates J, Bakke P, et al. Bronchodilator responsiveness as a phenotypic characteristic of established chronic obstructive pulmonary disease. Thorax. 2012;67:701–8.CrossRef Albert P, Agusti A, Edwards L, Tal-Singer R, Yates J, Bakke P, et al. Bronchodilator responsiveness as a phenotypic characteristic of established chronic obstructive pulmonary disease. Thorax. 2012;67:701–8.CrossRef
22.
Zurück zum Zitat Dellacà R, Pompilio P, Walker P, Duffy N, Pedotti A, Calverley P. Effect of bronchodilation on expiratory flow limitation and resting lung mechanics in COPD. Eur Respir J. 2009;33:1329–37.CrossRef Dellacà R, Pompilio P, Walker P, Duffy N, Pedotti A, Calverley P. Effect of bronchodilation on expiratory flow limitation and resting lung mechanics in COPD. Eur Respir J. 2009;33:1329–37.CrossRef
23.
Zurück zum Zitat Yildiz P, Bayraktaroglu M, Gorgun D, Secik F. Bronchodilator efficacy of 18 μg once-daily tiotropium inhalation via Discair® versus HandiHaler® in adults with chronic obstructive pulmonary disease: randomized, active-controlled, parallel-group, open-label, phase IV trial. Int J COPD. 2016;11:2859–67.CrossRef Yildiz P, Bayraktaroglu M, Gorgun D, Secik F. Bronchodilator efficacy of 18 μg once-daily tiotropium inhalation via Discair® versus HandiHaler® in adults with chronic obstructive pulmonary disease: randomized, active-controlled, parallel-group, open-label, phase IV trial. Int J COPD. 2016;11:2859–67.CrossRef
24.
Zurück zum Zitat Lopez-Campos JL, Calero C, Lopez-Ramirez C, Asensio-Cruz MI, Márquez-Martín E, Ortega-Ruiz F. Patient-reported outcomes and considerations in the management of COPD: focus on aclidinium. Patient Prefer Adher. 2015;9:95–104.CrossRef Lopez-Campos JL, Calero C, Lopez-Ramirez C, Asensio-Cruz MI, Márquez-Martín E, Ortega-Ruiz F. Patient-reported outcomes and considerations in the management of COPD: focus on aclidinium. Patient Prefer Adher. 2015;9:95–104.CrossRef
25.
Zurück zum Zitat Vincken W, van Noord JA, Greefhorst APM, et al. Improved health outcomes in patients with COPD during 1 yr’s treatment with tiotropium. Eur Respir J. 2002;19:209–16.CrossRef Vincken W, van Noord JA, Greefhorst APM, et al. Improved health outcomes in patients with COPD during 1 yr’s treatment with tiotropium. Eur Respir J. 2002;19:209–16.CrossRef
26.
Zurück zum Zitat Lopez-Campos JL, Bustamante V, Munoz X, Barreiro E. Moving towards patient-centered medicine for COPD management: multidimensional approaches versus phenotype-based medicine-a critical view. Chronic Obstr Pulm Dis. 2014;11:591–602.CrossRef Lopez-Campos JL, Bustamante V, Munoz X, Barreiro E. Moving towards patient-centered medicine for COPD management: multidimensional approaches versus phenotype-based medicine-a critical view. Chronic Obstr Pulm Dis. 2014;11:591–602.CrossRef
27.
Zurück zum Zitat Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.CrossRef Vestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.CrossRef
28.
Zurück zum Zitat Decramer M, Molenberghs G, Liu D, Celli B, Kesten S, Lystig T, UPLIFT Investigators, et al. Premature discontinuation during the UPLIFT study. Respir Med. 2011;105:1523–30.CrossRef Decramer M, Molenberghs G, Liu D, Celli B, Kesten S, Lystig T, UPLIFT Investigators, et al. Premature discontinuation during the UPLIFT study. Respir Med. 2011;105:1523–30.CrossRef
29.
Zurück zum Zitat Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;180:741–50.CrossRef Welte T, Miravitlles M, Hernandez P, Eriksson G, Peterson S, Polanowski T, et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;180:741–50.CrossRef
30.
Zurück zum Zitat Calverley PM, Boonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Respir J. 2003;22:912–9.CrossRef Calverley PM, Boonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Respir J. 2003;22:912–9.CrossRef
31.
Zurück zum Zitat Lipson DA, Barnacle H, Birk R, Brealey N, Locantore N, Lomas DA, et al. FULFIL trial: once-daily triple therapy for patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;196:438–46.CrossRef Lipson DA, Barnacle H, Birk R, Brealey N, Locantore N, Lomas DA, et al. FULFIL trial: once-daily triple therapy for patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;196:438–46.CrossRef
32.
Zurück zum Zitat Latorre M, Novelli F, Vagaggini B, Braido F, Papi A, Sanduzzi A, et al. Differences in the efficacy and safety among inhaled corticosteroids (ICS)/long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): role of ICS. Pulm Pharmacol Ther. 2015;30:44–50.CrossRef Latorre M, Novelli F, Vagaggini B, Braido F, Papi A, Sanduzzi A, et al. Differences in the efficacy and safety among inhaled corticosteroids (ICS)/long-acting beta2-agonists (LABA) combinations in the treatment of chronic obstructive pulmonary disease (COPD): role of ICS. Pulm Pharmacol Ther. 2015;30:44–50.CrossRef
33.
Zurück zum Zitat Sharafkhaneh A, Mattewal AS, Abraham VM, Dronavalli G, Hanania NA. Budesonide/formoterol combination in COPD: a US perspective. Int J Chron Obstr Pulmon Dis. 2010;5:357–66.CrossRef Sharafkhaneh A, Mattewal AS, Abraham VM, Dronavalli G, Hanania NA. Budesonide/formoterol combination in COPD: a US perspective. Int J Chron Obstr Pulmon Dis. 2010;5:357–66.CrossRef
34.
Zurück zum Zitat Janson C, Lööf T, Telg G, Stratelis G, Nilsson F. Difference in resistance to humidity between commonly used dry powder inhalers: an in vitro study. NPJ Prim Care Respir Med. 2016;26:16053.CrossRef Janson C, Lööf T, Telg G, Stratelis G, Nilsson F. Difference in resistance to humidity between commonly used dry powder inhalers: an in vitro study. NPJ Prim Care Respir Med. 2016;26:16053.CrossRef
35.
Zurück zum Zitat Price D. The way forward: dry powder inhalers should only be switched with physician agreement and patient training. Int J Clin Pract Suppl. 2005;149:36–7.CrossRef Price D. The way forward: dry powder inhalers should only be switched with physician agreement and patient training. Int J Clin Pract Suppl. 2005;149:36–7.CrossRef
36.
Zurück zum Zitat Product characterization report: Neutec Ar-Ge San. Ve Tic.A.S. 2018; Neutec Document No. NRD-26-18-023.R. Product characterization report: Neutec Ar-Ge San. Ve Tic.A.S. 2018; Neutec Document No. NRD-26-18-023.R.
37.
Zurück zum Zitat Chrystyn H, Small M, Milligan G, Higgins V, Gil EG, Estruch J. Impact of patients’ satisfaction with their inhalers on treatment compliance and health status in COPD. Respir Med. 2014;108:358–65.CrossRef Chrystyn H, Small M, Milligan G, Higgins V, Gil EG, Estruch J. Impact of patients’ satisfaction with their inhalers on treatment compliance and health status in COPD. Respir Med. 2014;108:358–65.CrossRef
Metadaten
Titel
Bronchodilator Efficacy of a Single-Dose 12/400-µg Formoterol/Budesonide Combination as a Dry Powder for Inhalation Delivered by Discair® in Adult Patients with Moderate-to-Severe Stable COPD: Open-Label, Single-Arm, Phase IV Trial
verfasst von
Pinar Yildiz
Mesut Bayraktaroglu
Didem Gorgun
Kivanc Yuksel
Publikationsdatum
01.10.2019
Verlag
Springer International Publishing
Erschienen in
Clinical Drug Investigation / Ausgabe 10/2019
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-019-00828-y

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