Background and purpose: Fixed-dose combinations of a long-acting beta agonist and an inhaled corticosteroid are more effective than the individual components in COPD. The primary study objective was to demonstrate that the combination indacaterol acetate/mometasone furoate (IND/MF [QMF149]) was non-inferior to the twice-daily combination salmeterol xinafoate/fluticasone propionate (Sal/Flu) in terms of trough FEV1 at week 12 (day 85). Secondary objectives were to compare the efficacy of IND/MF (QMF149) vs Sal/Flu with respect to other lung function parameters, COPD exacerbations, symptoms and dyspnea, health status/health-related quality of life, and rescue medication use. Materials and methods: This was a 12-week multicenter, randomized, double-blind, double-dummy, parallel-group, Phase II study in patients with moderate-to-very-severe COPD, who were randomized (1:1) to IND/MF (QMF149) (150/160 microg once daily; n=316) or Sal/Flu (50/500 microg twice daily; n=313). Results: Over 90% of patients completed the study: 94.6% in the IND/MF (QMF149) group and 92.0% in the Sal/Flu group. The primary objective of non-inferiority of IND/MF (QMF149) to Sal/Flu for trough FEV1 at week 12 (day 85) was met: the lower limit of the CI (95% CI: 27.7, 83.3 mL) was greater than -60 mL. The analysis for superiority of IND/MF (QMF149) to Sal/Flu demonstrated superiority of IND/MF (QMF149), with a difference of 56 mL (P<0.001). In addition, IND/MF (QMF149) treatment significantly improved COPD exacerbation-related parameters during the 12-week period. Other significant improvements with IND/MF (QMF 149) vs Sal/Flu were noted for dyspnea at week 12 and other COPD symptoms and COPD rescue medication use over the 12 weeks. The safety and tolerability profiles of both the treatments were similar. Conclusion: IND/MF (QMF149) (150/160 microg once daily) offered superior lung function and symptom efficacy and a favorable safety profile compared with Sal/Flu (50/500 microg twice daily) in patients with moderate-to-very severe COPD.
- Beeh, K. M.
- Kirsten, A. M.
- Tanase, A. M.
- Richard, A.
- Cao, W.
- Hederer, B.
- Beier, J.
- Kornmann, O.
- van Zyl-Smit, R. N.
Keywords
- Copd
- LABA/ICS combinations
- fixed-combination inhalers
- indacaterol
- mometasone
- once-daily inhalers
- of Novartis Pharmaceuticals Corporation. KMB declares that no personal payments
- were received from any pharmaceutical entity in the past 5 years. KMB and JB are
- full-time employees of Insaf Respiratory Research Institute. AMK is an employee
- of the Pulmonary Research Institute at LungClinic Grosshansdorf. AMK received
- speaking honoraria, honoraria for participation in advisory board meetings, and
- travel support for attending congresses in respiratory medicine from Boehringer
- Ingelheim, AstraZeneca, and Novartis. RNVZS has received honoraria for academic
- work from Novartis, AZ, CIPLA, ASPEN, Pfizer, GSK, and MSD. The authors report no
- other conflicts of interest in this work.
