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Randomized Trial of Once-Daily Fluticasone Furoate in Children with Inadequately Controlled Asthma
Amanda J Oliver1, Ronina A Covar2, Caroline H Goldfrad1
1Respiratory Therapy Area, GlaxoSmithKline, Uxbridge, UK.
Insights
Fluticasone furoate (FF) and fluticasone propionate (FP) significantly improved lung function in children with asthma. Both treatments were well-tolerated, showing no new safety concerns in this 12-week study.
Area of Science:
- Pediatric Pulmonology
- Pharmacology and Therapeutics
- Respiratory Medicine
Background:
- Asthma is a common chronic respiratory disease in children.
- Inhaled corticosteroids are a cornerstone of asthma management.
- Fluticasone furoate (FF) is a newer inhaled corticosteroid with potential benefits.
Purpose of the Study:
- To assess the dose-response relationship, efficacy, and safety of once-daily evening FF (25µg, 50µg, 100µg) in children with inadequately controlled asthma.
- To compare FF with placebo and an active comparator, fluticasone propionate (FP).
Main Methods:
- Phase IIb, multicenter, randomized, double-blind, double-dummy, placebo- and active-controlled study.
- 593 children aged 5-11 years with inadequately controlled asthma were randomized.
- 12-week treatment period evaluating daily morning peak expiratory flow (PEF) and adverse events.
Main Results:
- All FF doses (25µg, 50µg, 100µg) and FP 100µg showed statistically significant improvements in mean change from baseline morning PEF compared to placebo (P<.001).
- The incidence of adverse events was slightly higher in FF groups (32-36%) than placebo (29%), with cough being the most frequent.
- No new safety concerns were identified across all treatment groups.
Conclusions:
- Once-daily evening FF demonstrates significant efficacy in improving lung function in children with inadequately controlled asthma.
- FF and FP are effective and well-tolerated treatment options for pediatric asthma.
- The study supports the use of FF as a potential therapeutic option for children with asthma.
Objective:
To evaluate the dose-response, efficacy, and safety of fluticasone furoate (FF; 25 µg, 50 µg, and 100 µg), administered once daily in the evening during a 12-week treatment period to children with inadequately controlled asthma.
Study Design:
This was a Phase IIb, multicenter, stratified, randomized, double-blind, double-dummy, parallel-group, placebo- and active-controlled study in children aged 5-11 years with inadequately controlled asthma. The study comprised a 4-week run-in period, 12-week treatment period, and 1-week follow-up period. Children were randomized to receive either placebo once daily, fluticasone propionate (FP) 100 µg twice daily, FF 25 µg, FF 50 µg, or FF 100 µg each once daily in the evening. Primary endpoint was the mean change from baseline in daily morning peak expiratory flow (PEF) averaged over weeks 1-12. Adverse events (AEs) also were investigated.
Results:
In total, 593 children were included in the intent-to-treat population. The difference vs placebo in change from baseline daily morning PEF averaged over weeks 1-12 was statistically significant for the FF 25, FF 50, FF 100, and FP 100 groups (18.6 L/min, 19.5 L/min, 12.5 L/min, and 14.0 L/min, respectively; P < .001 for all). The incidence of AEs was greater in the FF groups (32%-36%) than in the placebo group (29%); the most frequent AE was cough.
Conclusion:
FF and FP resulted in significant improvements in morning PEF compared with placebo, suggesting that they are effective treatments for children with inadequately controlled asthma. All treatments were well tolerated; no new safety concerns were identified.
Trial Registration:
ClinicalTrials.gov:NCT01563029.
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