GlaxoSmithKline’s once-daily triple therapy, the Trelegy Ellipta (fluticasone furoate, umeclidinium, vilanterol), is superior to dual combination therapies in reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD) with a history of exacerbations, new research suggests.
The landmark IMPACT study published in the New England Journal of Medicine found the triple therapy achieved superior results to the Breo Ellipta and the Anoro Ellipta. Unlike the Breo and Anoro, which administer two different drugs, the Trelegy administers three medications: the corticosteroid fluticasone, the anticholinergic umeclidinium, and vilanterol, a long-acting beta-agonist.
The study was a phase III randomized multicenter trial involving more than 10,000 patients with COPD over 40 years of age. Patients were administered with the medication over a 52 week period. The primary endpoint of the study was a reduction in the annual rate of on-treatment moderate/severe exacerbations. The Trelegy Ellipta achieved a 34 percent reduction in COPD hospitalizations compared to the Anora and a 13 percent reduction when compared to the Breo.
Furthermore, the study also found the triple therapy was superior in other important clinical outcomes, including lung function and health-related quality of life. Compared to the Anoro, the Trelegy achieved a 42.1 percent reduction in the risk of on-treatment all-cause mortality.
It concluded that the rate of moderate or severe exacerbations was significantly lower in patients treated with the triple therapy inhaler than those using a dual therapy. It also found a lower rate of hospitalization due to COPD in patients treated with a combination of fluticasone furoate, umeclidinium, and vilanterol.
Fernando Martinez, MD, chief of the Division of Pulmonary and Critical Care Medicine at New York-Presbyterian Hospital/Weill Cornell Medical Center, explained that comparison of different combinations of medications administered with the same device helped clarify which type of patients benefit most from each class of medicine.
“As many patients experience frequent exacerbations or ‘flare-ups’, which can often result in hospitalization, these data will be highly relevant to patients and clinicians as they consider the optimal treatment,” he added.
COPD refers to a group of diseases that cause blockages in the airflow and breathing-related problems, such as emphysema, chronic bronchitis, and asthma. Tobacco smoke is one of the key causes in the development and progression of COPD, but other pollutants can also play a role. Chronic lower respiratory disease (of which COPD is one of the main varieties) is the third leading cause of death in the United States. In 2014, more than 15.7 million Americans were living with diagnosed COPD.