EX-99.1 2 a12-19541_2ex99d1.htm EX-99.1

Exhibit 99.1

 

Lung function effects and safety of fluticasone furoate (FF)/vilanterol (VI) in patients with COPD: low-mid dose assessment Kerwin EM1, Scott-Wilson C2, Sanford L3, Rennard SI4, Agusti A5, Barnes N6, Crim C2 1. Clinical Research Institute of Southern Oregon, Medford, OR, USA; 2. GlaxoSmithKline, Research Triangle Park, NC, USA; 3. GlaxoSmithKline, Stockley Park, London, UK; 4. University of Omaha, Nebraska, OH, USA; 5. Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and FISIB, CIBERES, Mallorca, Spain; 6. Respiratory Medicine, Barts and The London NHS Trust, London, UK

 


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CONFLICT OF INTEREST DISCLOSURE Edward Kerwin, M.D. has served on Advisory Boards for Astra Zeneca, Forest, Ironwood, Mylan, Pearl, Sanofi, Sunovion and Targacept; Speakers Panels for AstraZeneca, Pfizer, Sanofi, and Sunovion; and has received travel reimbursement from Merck, Forest and Novartis. He has conducted clinical trials for multiple pharmaceutical companies, including GlaxoSmithKline

 


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Introduction An inhaled corticosteroid (ICS) combined with a long-acting beta2 agonist (LABA) is an established treatment for COPD patients experiencing impaired airway function or acute exacerbations Fluticasone furoate (FF) and vilanterol (VI) are respectively, a novel ICS and LABA, in development as a once-daily combination therapy for COPD and asthma

 


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Objectives Post-Dose & Trough Lung Function Effects 24-week efficacy of VI Addition of FF to VI Dose Range FF when added to VI Symptoms Safety

 


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FF 100mcg (N=206) VI 25mcg (N=205) FF/VI 50/25mcg (N=206) FF/VI 100/25mcg (N=206) Placebo (N=207) R F S Clinic Visit (Day) 1 (-14 to -17) 2 (1) 3 (2) 4 (7) 5 (14) 6 (28) 7 (56) 8 (84) 9 (112) 10 (140) 11 (168) 12 (169) Phone (176±2) Study design

 


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Endpoints Co-primary Weighted mean FEV1 (0-4hr) post-dose, Day 168 Change from baseline Trough FEV1, Day 169 Secondary CRQ-SAS dyspnoea domain Peak FEV1 (0-4hr) post-dose, Day 1 Time to 100mL (0-4hr) post-dose, Day 1 Safety

 


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VI 25 vs. Placebo FF/VI 100/25 vs. Placebo FF/VI 100/25 vs. FF 100 wmFEV1(0-4hr) Day 168 Trough FEV1 Day 169 VI 25 vs. Placebo FF/VI 100/25 vs. Placebo FF/VI 100/25 vs. VI 25 Co-Primary , FF/VI 100/25 Secondary, FF/VI 100/25 FF/VI 100/25 vs. Placebo for each endpoint FF/VI 50/25 vs. Placebo FF/VI 50/25 vs. Placebo FF/VI 50/25 vs. VI 25 wmFEV1(0-4hr) Day 168 Trough FEV1 Day 169 Co-Primary , FF/VI 50/25 LEVEL 1 LEVEL 2 LEVEL 3 Move to Level 2 if p<0.05 for all Secondary , FF/VI 50/25 FF/VI 50/25 vs. Placebo for each endpoint Move to Level 3 if p<0.05 for all Study power: 80mL for FF/VI vs. VI Trough FEV1 Day 169 100mL for FF/VI vs. Placebo Trough FEV1 Day 169 100mL for FF/VI vs. FF wmFEV1 (0-4hr) Day 168

 


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Characteristics Total (N=1030) Mean Age, yr (SD) 62.7 (9.09) Male Sex, n (%) 685 (67) Mean Post-BD FEV1, L (SD) 1.406 (0.48) Mean Post-BD %pred FEV1, % (SD) 48.3 (12.45) GOLD stage, n (%) II III IV 487 (47) 445 (43) 94 (9) Mean mMRC dyspnoea, score (SD) 2.4 (0.5) Moderate* exacerbations, n (%) 0 1 2 >2 787 (76) 202 (20) 31 (3) 10 (<1) *requiring systemic corticosteroids and/or antibiotics

 


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wmFEV1 (0-4hr): VI vs. PBO Day 168 Test mL (95% CI) p VI – PBO 103 (52, 153) <0.001 0 1 Day wm FEV1 (L), LS mean (95% CI) 1.2 1.3 1.4 1.5 1 14 56 84 168 Placebo VI 25

 


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Trough FEV1: VI vs. PBO Day 169 Test mL (95% CI) p VI – PBO 67 (12, 121) 0.017 -0.05 Day Trough FEV1 (L), LS mean change from baseline (95% CI) 0.00 0.05 0.10 0.15 0.20 0.25 2 7 14 28 56 84 112 140 168 169 Placebo VI 25

 


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wmFEV1 (0-4hr): FF/VI vs. PBO Day 168 Test mL (95% CI) p FF/VI 100/25 – PBO 173 (123, 224) <0.001 FF/VI 50/25 – PBO* 192 (141, 243) - 0 1 Day wm FEV1 (L), LS mean (95% CI) 1.2 1.3 1.4 1.5 1 14 56 84 168 Placebo FF/VI 50/25 FF/VI 100/25 *p-value not shown due to statistical hierarchy; difference is descriptive only

 


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Trough FEV1: FF/VI vs. PBO Day 169 Test mL (95% CI) p FF/VI 100/25 – PBO 115 (60, 169) <0.001 FF/VI 50/25 – PBO* 129 (74, 184) - -0.05 Day Trough FEV1 (L), LS mean change from baseline (95% CI) 0.00 0.05 0.10 0.15 0.20 0.25 2 7 14 28 56 84 112 140 168 169 Placebo FF/VI 50/25 FF/VI 100/25 *p-value not shown due to statistical hierarchy; difference is descriptive only

 


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wmFEV1 (0-4hr): FF/VI vs. FF Day 168 Test mL (95% CI) p FF/VI 100/25 – FF 120 (70, 170) <0.001 0 1 Day wm FEV1 (L), LS mean (95% CI) 1.2 1.3 1.4 1.5 1 14 56 84 168 FF 100 FF/VI 50/25 FF/VI 100/25

 


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Trough FEV1: FF/VI vs. VI Day 169 Test mL (95% CI) p FF/VI 100/25 – VI 48 (-6, 102) 0.082 FF/VI 50/25 – VI* 62 (8, 117) - -0.05 Day Trough FEV1 (L), LS mean change from baseline (95% CI) 0.00 0.05 0.10 0.15 0.20 0.25 2 7 14 28 56 84 112 140 168 169 VI 25 FF/VI 50/25 FF/VI 100/25 *p-value not shown due to statistical hierarchy; difference is descriptive only

 


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CRQ-SAS dyspnoea domain: Day 168 Test Units(95% CI) VI – Placebo 0.14 (-0.10, 0.38) FF 100 – Placebo 0.06 (-0.18, 0.30) FF/VI 50/25 – Placebo 0.19 (-0.05, 0.43) FF/VI 100/25 – Placebo 0.30 (0.06, 0.54) FF/VI 50/25 – VI 25 0.05 (-0.19, 0.29) FF/VI 100/25 – VI 25 0.16 (-0.08, 0.40) FF/VI 100/25 – FF 100 0.24 (0.01, 0.48) Differences are descriptive only due to statistical hierarchy Range: 1 – maximum impairment, 7 – no impairment; MCID > 0.5 Units

 


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Peak FEV1 (0-4hr): Day 1 Test mL(95% CI) VI – Placebo 142 (114, 169) FF 100 – Placebo 12 (-15, 39) FF/VI 50/25 – Placebo 148 (120, 175) FF/VI 100/25 – Placebo 139 (112, 166) FF/VI 50/25 – VI 25 6 (-22, 33) FF/VI 100/25 – VI 25 -3 (-30, 25) FF/VI 100/25 – FF 100 127 (100, 154) Differences are descriptive only due to statistical hierarchy

 


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Time to 100mL (0-4h): Day 1 MEDIAN TIME 100mL Treatment Min Placebo n/a FF 100 n/a VI 25 16 FF/VI 100/25 17 FF/VI 50/25 17 Serial FEV1: Day 1 (0-4h) n/a = not applicable as >50% of patients did not achieve a 100mL improvement by 4hr Placebo FF 100 VI 25 FF/VI 50/25 FF/VI 100/25 Time - Day 1 Change from baseline FEV1 (L) mean (SD) 0.0 0.2 0.4 5min 15min 30min 1hr 2hr 4hr 0.1 0.3

 


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Safety Placebo N=207 FF 100 N=206 VI 25 N=205 FF/VI 50/25 N=206 FF/VI 100/25 N=206 ANY EVENT, n (%) On-Treatment AEs 100 (48) 123 (60) 111 (54) 114 (55) 111 (54) On-Treatment SAEs 11 (5) 16 (8) 15 (7) 6 (3) 11 (5) EVENTS OF SPECIAL INTEREST, n (%) Cardiovascular Effects 16 (8) 18 (9) 15 (7) 15 (7) 11 (5) Local Steroid Effects 7 (3) 13 (6) 6 (3) 24 (12) 16 (8) LRTI excluding pneumonia 8 (4) 8 (4) 6 (3) 3 (1) 5 (2) Pneumonia 3 (1) 4 (2) 5 (2) 3 (1) 5 (2) Hypersensitivity 2 (<1) 5 (2) 3 (1) 1 (<1) 6 (3) Effects on Glucose 1 (<1) 4 (2) 1 (<1) 3 (1) 5 (2) Bone Disorders 4 (2) 2 (<1) 2 (<1) 1 (<1) 1 (<1) Ocular Effects 1 (<1) 2 (<1) 1 (<1) 1 (<1) 1 (<1) Systemic Steroid Effects 2 (<1) 0 0 2 (<1) 1 (<1) Effects on Potassium 1 (<1) 1 (<1) 0 0 0 Tremor 0 1 (<1) 0 0 0

 


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VI 25mcg provides sustained bronchodilation over 24 weeks in moderate-to-severe COPD Addition of FF to VI provides further bronchodilation Additional lung function effect not statistically significantly greater than VI alone VI has a negligible effect on dyspnoea Addition of FF at 100mcg provides a numerical improvement VI provides rapid substantial post-dose bronchodilation from Day 1 onward Addition of FF provides no more rapid or increased bronchodilation FF/VI exhibits a safety profile similar to that of its components and placebo Summary

 


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FF/VI represents a once-daily treatment option for moderate-to-severe COPD which is efficacious and well tolerated Conclusion