CHEST Annual Meeting

CHEST Annual Meeting

Source:

Lugogo NL, et al. Asthma: Challenges in Pediatric and Adult Patients. Presented at: CHEST Annual Meeting; Oct. 17-20, 2021 (virtual meeting).

Disclosures: GlaxoSmithKline funded the study. Lugogo reports serving on advisory boards and participating in clinical trials for AstraZeneca, Genentech, GlaxoSmithKline, Novartis, Regeneron, Sanofi and Teva; consulting with AstraZeneca; and receiving funds from AKH and Medscape.
October 19, 2021
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Benefits of triple therapy consistent regardless of age at asthma onset

Source:

Lugogo NL, et al. Asthma: Challenges in Pediatric and Adult Patients. Presented at: CHEST Annual Meeting; Oct. 17-20, 2021 (virtual meeting).

Disclosures: GlaxoSmithKline funded the study. Lugogo reports serving on advisory boards and participating in clinical trials for AstraZeneca, Genentech, GlaxoSmithKline, Novartis, Regeneron, Sanofi and Teva; consulting with AstraZeneca; and receiving funds from AKH and Medscape.
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Improvements observed with triple therapy with umeclidinium, fluticasone furoate and vilanterol, and use of a higher fluticasone furoate dose, were consistent regardless of age at asthma onset, according to new data from the CAPTAIN study.

Njira Lucia Lugogo, MD, clinical associate professor at the University of Michigan Ann Arbor, presented a new post hoc analysis of the CAPTAIN study looking at the effects of age of asthma onset as a continuous variable on treatment outcomes at the CHEST Annual Meeting.

Asthma inhaler held by woman
Source: Shutterstock.

The once-daily, single-inhaler triple therapy (Trelegy Ellipta, GlaxoSmithKline) combines umeclidinium, a long-acting muscarinic antagonist; fluticasone furoate, an inhaled corticosteroid (ICS); and vilanterol, a long-acting beta-2 adrenergic agonist. Trelegy Ellipta is approved by the FDA for treatment in patients with COPD and asthma.

“The CAPTAIN study showed that adding umeclidinium to fluticasone furoate and vilanterol ... improved lung function and symptom control and led to numerical reductions in the annualized rate of moderate severe exacerbations in patients with uncontrolled asthma despite inhaled corticosteroid and LABA therapy,” Lugogo said during a presentation. “Previous categorical subgroup analyses of CAPTAIN showed that response to [triple therapy] may vary according to the age at which a patient develops asthma.”

The CAPTAIN study included 2,436 adults (mean age, 53.2 years; 38% men) with asthma uncontrolled by ICS and LABA therapy.

Researchers evaluated change from baseline in trough FEV1 at 24 weeks and the annualized rate of moderate to severe asthma exacerbations according to age at asthma onset.

Mean age at onset of asthma was 32 years. Mean duration of asthma was 21 years, Lugogo said..

Umeclidinium 62.5 mcg added to fluticasone furoate/vilanterol was associated with numerically greater improvements in trough FEV1 (approximately 100 mL) independent of age at asthma onset compared with fluticasone furoate/vilanterol alone, according to the results.

Use of the higher fluticasone furoate dose (200 mcg vs. 100 mcg) was also associated with improvements in trough FEV1 regardless of age at asthma onset. The improvement in trough FEV1 was less pronounced with the higher fluticasone furoate dose than the improvement observed with triple therapy, Lugogo said.

In addition, fluticasone furoate 200 mcg was associated with greater reductions in annualized asthma exacerbations across the range of age of asthma onset compared with the 100 mcg dose, according to the results.

Lugogo said it is important to note that greater uncertainty exists at the extremes of the age-of-onset range due to fewer patients at each end of the spectrum.

Patients with asthma inadequately controlled on ICS/LABA would benefit from the addition of umeclidinium to fluticasone furoate/vilanterol triple therapy or from the use of a higher dose of fluticasone furoate irrespective of age of asthma onset,” Lugogo said.

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