Recent Updates
Recently added Catalysts

fluticasone propionate/salmeterol

Phase 3

Asthma | Small molecule | Respiratory |GSK plc|Last Updated: Oct 11, 2018

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
Premium
Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
Premium
Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDBiomarker
Total Trials9
Total Enrollment2,022
FDA Designations
No designations recorded
Clinical Trials (9)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01687296Nebulized Fluticasone Propionate VS Oral Prednisone in Chinese Pediatric and Adolescent Subjects With an Acute Exacerbation of AsthmaPHASE3 COMPLETED 261Nov 12, 2012Jun 21, 2013Jun 20, 201811 China
NCT01687283Efficacy and Safety Study of Fluticasone Proponate Inhalation Solution in Adult and Adolescent AsthmaPHASE3 COMPLETED 316Sep 27, 2012Nov 7, 2013Oct 11, 201825 China
NCT01159912Evaluating the Efficacy and Safety of Fluticasone Furoate Inhalation Powder in the Treatment of Asthma in Adults and AdolescentsPHASE3 COMPLETED 350Jun 30, 2010Jan 16, 2012Nov 9, 201782 United States, Belgium +3
NCT00441441A 12-Week Study To Assess The Safety Of Fluticasone Propionate/Salmeterol 100/50 Hydrofluoroalkane (HFA) Versus Fluticasone Propionate 100 HFA In Children With AsthmaPHASE3 COMPLETED 351Feb 1, 2007Jan 1, 2008Dec 16, 201655 United States, Australia +11
NCT00158834Pediatric Asthma Study Using Stepwise Treatment With Two Food And Drug Administration Approved Asthma MedicationsPHASE3 COMPLETED 200Nov 1, 1999 -Oct 13, 200816 Netherlands
NCT01573767Dose-ranging Study of Vilanterol (VI) Inhalation Powder in ChildrenPHASE2 COMPLETED 463Apr 1, 2012Apr 1, 2014Jan 9, 2017120 United States, Argentina +12
NCT00369993Spacer Comparison In Adult AsthmaticsPHASE2 COMPLETED 20Mar 1, 2005May 1, 2005Oct 17, 20161 New Zealand
NCT00400855Study on the Effects of an AMP Challenge on Asthmatic Patients Following Treatment With Fluticasone PropionatePHASE2 COMPLETED 49Jan 1, 2005Aug 1, 2005Sep 15, 20162 New Zealand
NCT00364442Repeat Dose Study of Fluticasone Propionate/Salmeterol Versus Fluticasone Propionate + Salmeterol In AsthmaticsPHASE1 COMPLETED 12Jan 28, 2005Apr 13, 2005Sep 29, 20171 Germany
Unlock Drug Trial Details
Study Endpoints
Primary Endpoints
Mean Morning Peak Expiratory Flow (AM PEF) on Diary Card Over the Treatment Assessment Period in Intent-to-Treat (ITT) Population
Days 2 to 8

PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before taking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 4 participants from prednisone group had the missing outcome measure. Analysis was performed using an analysis of covariance (ANCOVA) model with effects due to gender, age, centre and treatment group.

Mean Morning PEF on Diary Card Over the Treatment Assessment Period in Per Protocol (PP) Population
Days 2 to 8

PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before talking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 5 participants from prednisone group had the missing outcome measure. Analysis was performed using ANCOVA model with effects due to gender, age ,centre and treatment group.

Change From Baseline (Day 1 of Treatment Period/Visit 2) in Morning Peak Expiratory Flow (AM PEF) Over 12 Weeks in Intent-to-treat Population
Baseline (Visit 2) and up to Week 12

The peak expiratory flow (PEF) is a person's maximum speed of expiration, A peak flow meter was issued to participants at Visit 1 to measure the morning PEF prior to study drug and rescue medication. The best of three attempts was recorded by the participants in the diary cards. Baseline value was the assessment at Visit 2. The raw and change from baseline in daily AM PEF averaged over the 12-week treatment period The mean value was considered missing if less than 4 days were recorded in the baseline week prior to randomization or if less than 4 days are recorded after randomization. Analysis was performed using analysis of covariance (ANCOVA) model. Abbreviations used in statistical analysis section: standard deviation (SD) and significance (sig)

Change From Baseline (Day 1 of Trt Period/Visit 2) in AM PEF Over 12 Weeks in Per Protocol Population
Baseline (Visit 2) and up to Week 12

The peak expiratory flow (PEF) is a person's maximum speed of expiration, A peak flow meter was issued to participants at Visit 1 to measure the morning PEF prior to study drug and rescue medication. The best of three attempts was recorded by the participants in the diary cards. Baseline value was the assessment at Visit 2. The raw and change from baseline in daily AM PEF averaged over the 12-week treatment period The mean value was considered missing if less than 4 days were recorded in the baseline week prior to randomization or if less than 4 days are recorded after randomization. Analysis was performed using analysis of covariance (ANCOVA) model.

Mean Change From Baseline in Clinic Visit Trough Evening (Pre-bronchodilator and Pre-dose) Forced Expiratory Volume in One Second (FEV1) at the End of the 24 Week Treatment Period
Baseline and Week 24

FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. Trough FEV1 is defined as the clinic visit (pre-bronchodilator and pre-dose) FEV1 measurement taken at the clinic visit at the end of the dosing interval. Pre-dose and pre-rescue albuterol/salbutamol trough FEV1 was measured electronically by spirometry in the evening at the Baseline through Week 24 clinic visits. The highest of 3 technically acceptable measurements was recorded. Baseline was the pre-dose value obtained at Visit 2. Change from Baseline was calculated as the Week 24 value minus the Baseline value. Analysis was performed using analysis of covariance (ANCOVA) with covariates of Baseline, region, sex, age, and treatment. The last observation carried forward (LOCF) method was used to impute missing data, in which the last non-missing post-Baseline on-treatment measurement at scheduled clinic visits was used to impute the missing measurements.

Possible Drug-Related Adverse Events
Treatment period (weeks 1-12) and Post Treatment (≥1 day after last time study drug)

Adverse Events reported by the Investigator and judged by the Investigator to be possibly related to study drug, categorized by the Medical Dictionary for Regulatory Activities (MeDRA), were reported. ECG, electrocardiogram. QTc (corrected QT interval) and QT represent intervals on an ECG.

Investigator Evaluations of Electrocardiogram (ECG) Results
Baseline and Week 12

ECGs were transmitted to an independent cardiologist who was responsible for providing interpretation of the ECG as either normal or abnormal (based on personal assessment). The investigator was then responsible for determining the clinical significance of the abnormal ECG in the context of the participants' history and clinical presentation. An abnormal, clinically significant ECG included, but was not limited to: prolonged QT interval, ischemic changes, ventricular hypertrophy, intraventricular conduction abnormalities, and clinically significant arrhythmias. PD, premature discontinuation.

Clinically Significant Unfavorable ECGs at Week 12
Baseline, Week 12

Post-randomization ECGs categorized by the primary investigator as no change, significant change (favorable), significant change (unfavorable) from the ECG performed at Visit 1 (Baseline) are presented. Significant change (favorable) includes any ECG that improved from baseline, whereas significant change (unfavorable) includes any ECG that worsened from baseline. Clinical significance is determined by the primary investigator.

ECG Measures - Heart Rate
Baseline and Week 12

The range of heart rates for this study was between 49-144 beats per minute

ECG Measures - QT Interval
Baseline and Week 12

Fridericia's formula QTc interval=QT interval/cubed root of the R-R interval. The Bazett's formula QTc=QT/squared root of the R-R interval.

Cardiovascular Adverse Events Reported During Treatment Period
12-Week Treatment Period

Cardiovascular Adverse Events, as categorized by the Medical Dictionary for Regulatory Activities (MeDRA), reported during Treatment Period. The Adverse Events were identified in any ECG interpretation by a central reader (Cardiologist) for any ECG obtained after the first treatment dose and were then reported by the Primary Investigator as an Adverse Event. Please see the category titles for a list of candidate cardiovascular adverse events.

Cardiovascular Adverse Events Reported During the Post-Treatment Period
5 Days after Week 12

Cardiovascular Adverse Events, as categorized by the Medical Dictionary for Regulatory Activities (MeDRA), reported during Post-treatment period, defined as 1 day after last dose of study drug. The Adverse Events were identified in any ECG interpretation by a central reader (Cardiologist) for any ECG obtained after the first treatment dose and were then reported by the Primary Investigator as an Adverse Event.

Asthma Exacerbations: Worsening of Asthma Requiring Emergency Intervention, Hospitalization, or Treatment With Asthma Medications Prohibited by the Protocols
Treatment period (weeks 1-12)

The Primary Investigator determined the severity of the exacerbation based on the participant's clinical presentation and the investigator's understanding of the disease, the participant, and his or her clinical experiences. The severity of the exacerbation was not defined in the protocol. Mild: Usually treated at home. Prompt relief with inhaled short-acting beta2 agonist. Possible short course of oral systemic corticosteroids. Moderate: Usually requires office or emergency department visit. Relief with frequent inhaled short-acting beta2 agonist. Oral systemic corticosteroids; some symptoms last for 1-2 days after treatment begins. Severe: Usually requires emergency department visit and likely hospitalization. Partial relief with frequent inhaled short-acting beta2 agonist. Oral systemic corticosteroids; some symptoms last for more than 3 days after treatment begins. Adjunctive therapies are helpful.

Number of Participants With the Indicated Levels of 24-hour Urinary Cortisol Excretion
Baseline and week 12

"Abnormal high cortisol excretion" and "Abnormal low cortisol excretion" are defined as above the upper limit of normal and below the lower limit of normal, respectively. The normal range for cortisol levels vary by age and gender. An abnormality is defined as a value of 24-hour urinary cortisol excretion that is outside the normal range. The normal range for 24-hour urinary cortisol excretion was provided by the central laboratory.

Geometric Mean Values of 24-hour Urinary Cortisol Excretion at Baseline and Week 12
Baseline and Week 12

Normal range for Cortisol levels vary by age and gender. Geometric mean is the product of the values taken to the Nth root, where N is the number of values in the set of values.

Geometric Mean Ratio for Week12:Baseline for 24-hour Urinary Cortisol Excretion
Baseline and Week 12

Normal range for Cortisol levels vary by age and gender. The data provided are a direct calculation of the Week 12 geometric mean divided by the baseline value, nanomoles per 24 hours (nmol/24 hrs).

Number of Participants With the Indicated Levels of 24 Hour Urinary Cortisol Excretion by Spacer Use
Baseline and Week 12

AeroChamber Plus spacers were provided for participants who demonstrated the inability to coordinate the use of an Meter Dose Inhaler at Visit 1. AeroChamber Plus spacer delivers 22% more medication than the original AeroChamber and is available in three mask sizes and without a mask. "Abnormal high cortisol excretion" and "Abnormal low cortisol excretion" are defined as above the upper limit of normal and below the lower limit of normal, respectively. An abnormality is defined as a value of 24-hour urinary cortisol excretion that is outside the normal range. The normal range for 24-hour urinary cortisol excretion was provided by the central laboratory.

Geometric Mean Values of 24 Hour Urinary Cortisol Excretion by Spacer Use at Baseline and Week 12
Baseline and Week 12

AeroChamber Plus spacers were provided for participants who demonstrated the inability to coordinate the use of an Meter Dose Inhaler at Visit 1. AeroChamber Plus spacer delivers 22% more medication than the original AeroChamber and is available in three mask sizes and without a mask. Geometric mean is the product of the values taken to the Nth root, where N is the number of values in the set of values.

Geometric Mean Ratio for Week12: Baseline for 24 Hour Urinary Cortisol Excretion by Spacer Use
Baseline and Week 12

AeroChamber Plus spacers were provided for participants who demonstrated the inability to coordinate the use of an Meter Dose Inhaler at Visit 1. AeroChamber Plus spacer delivers 22% more medication than the original AeroChamber and is available in three mask sizes and without a mask. The data provided are a direct calculation of the Week 12 geometric mean divided by the baseline value, nanomoles per 24 hours (nmol/24 hrs).

Asthma symptom free days during the last 12 weeks of the treatment period.
Change From Baseline in Daily Pre-dose Evening (PM) Peak Expiratory Flow (PEF) From Participant Electronic Daily Diary Averaged Over the 4-week Treatment Period
Baseline; Week 1 up to Week 4

PEF is defined as the maximum airflow during a forced expiration beginning with the lungs fully inflated. PEF was measured by the participants using a hand-held electronic peak flow meter each evening prior to the dose of study medication and any rescue albuterol/salbutamol inhalation aerosol use each morning. The best of three measurements was recorded. Change from Baseline was calculated as the value of the averaged daily PM PEF over the 4-week Treatment Period minus the Baseline value. The Baseline PEF value is defined as the average of the last 7 days of the Run-in Phase. The analysis was performed using an analysis of covariance (ANCOVA) model with covariates of Baseline, region, sex, age, and treatment. Only those participants contributing data per the daily eDiary were analyzed.

The pharmacokinetic profile of fluticasone propionate (in particular the area under the curve to time t and the maximum concentration)
To characterise the dose response curve following repeat inhaled doses of FP for 5 days in the AMP challenge model.
5 days
The primary objective was to look at the safety and tolerability of a low dose of fluticasone propionate/salmeterol compared to concurrent administration of fluticasone propionate and salmeterol
Administration occurred over 14 days and tolerability
Secondary Endpoints
Mean Evening PEF on Diary Card Over the Treatment Assessment Period
Days 1/2 to 8
Median Day-time and Night-time Symptom Scores Over the Treatment Assessment Period
Days 2 to 8
Median Number of Use of Rescue Medications During Day and Night Over the Treatment Assessment Period
Days 2 to 8
Unlock Study Endpoints
Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
fluticasone Nebules/placebo tabletEXPERIMENTAL2×0.5mg/2ml twice daily neblulized/placebo tablet, oral, once daily
oral prednisone/placebo inhalation solutionACTIVE_COMPARATORonce daily (2mg/kg.day, up to 40mg/day for 4 days, then 1mg/kg.day or half of the original dose, up to 20mg/day for 3 days) / placebo inhalation solution nebulized twice daily
fluticasone propionateEXPERIMENTAL1 mg BID inhalation via nebulizer
budesonide suspensionACTIVE_COMPARATOR2 mg BID inhalation via nebulizer
Fluticasone Furoate OD and Placebo BIDEXPERIMENTALFluticasone furoate inhalation powder once daily and placebo inhalation powder twice daily for 24 weeks
Fluticasone Propionate BID and Placebo ODACTIVE_COMPARATORFluticasone propionate inhalation powder twice daily and placebo inhalation powder once daily for 24 weeks
Placebo only BIDPLACEBO_COMPARATORPlacebo inhalation powder twice daily for 24 weeks
Fluticasone propionate/salmeterol 100/50 HFAEXPERIMENTALFluticasone propionate/salmeterol 100/50 HFA (2 inhalations of 50/25mcg), twice daily (strengths are ex-valve) and a placebo HFA inhaler matching the fluticasone propionate 100mcg HFA inhaler (2 inhalations) twice daily
Fluticasone propionate 100mcg HFAEXPERIMENTALFluticasone propionate 100mcg HFA (2 inhalations of 50mcg), twice daily (strengths are ex-valve) and a placebo HFA inhaler matching the fluticasone propionate/salmeterol 100/50 HFA inhaler (2 inhalations ) twice daily
Arm 1ACTIVE_COMPARATORVilanterol 25mcg inhalation powder inhaled once daily in the PM via the new powder inhaler
Arm 2ACTIVE_COMPARATORVilanterol 12.5mcg inhalation powder inhaled once daily in the PM via the new powder inhaler
Arm 3ACTIVE_COMPARATORVilanterol 6.25mcg inhalation powder inhaled once daily in the PM via the new powder inhaler
Arm 4PLACEBO_COMPARATORPlacebo inhalation powder inhaled once daily in the PM via the new powder inhaler
Interventions
NameTypeDescription
fluticasone propionate inhalation solutionDRUG2×0.5mg/2ml twice daily nebulized to treat an acute exacerbation of asthma for 7 days
oral prednisoneDRUGonce daily (2mg/kg.day, up to 40mg/day for 4 days, then 1mg/kg.day or half of the original dose, up to 20mg/day for 3 days) to treat an acute exacerbation of asthma for 7 days
placebo inhalation solutionDRUG4ml 0.9% saline nebulized twice daily
placebo tabletDRUGplacebo soluble tablet, oral ,once daily
salbutamolDRUGSalbutamol MDI 2 puffs twice daily or Nebules twice daily, and can be increased up to every 4 hours on an as-needed basis, through the treatment period.
budesonide suspensionDRUG2 mg BID inhalation for 12 weeks with one possible chance to change to 1 mg BID
Fluticasone propionateDRUGFluticasone propionate inhalation powder, 250 µg
Fluticasone furoateDRUGFluticasone furoate inhalation powder, 100 µg
PlaceboDRUGPlacebo inhalation powder
fluticasone propionate/salmeterolDRUGfluticasone propionate/salmeterol 100/50mcg HFA
Salmeterol/Fluticasone propionate combination productDRUG -
Fluticasone propionate 100mcgDRUGall subjects recieve open-label Flovent twice daily duirng the run in and treatment period
VilanterolDRUGsubjects will recieve 4 weeks via NDPI during treament period
Unlock Study Design Details
Eligibility Criteria
Age Range4 Years — 16 Years
SexALL
Healthy VolunteersNo
Study Sites11

Inclusion Criteria: * Chinese male and female pediatric or adolescent subjects aged 4 to 16 years, inclusive * Subjects have an established diagnosis of asthma * The definition of asthma. According to Chinese Guideline for the diagnosis and optimal management of asthma in children \[Respiratory bra...

Countries:ChinaUnited StatesBelgiumGermanyPolandRomaniaAustraliaCanadaChileCosta RicaLatviaLithuaniaMexicoPeruRussiaSpainNetherlandsArgentinaGeorgiaJapanPhilippinesPuerto RicoSlovakiaSouth AfricaUkraineNew Zealand
Unlock Eligibility Criteria