Source: International Congress 2015 – New data on established treatments for asthma, COPD and bronchiectasis
Disease area: Airway diseases

Abstract

The GLISTEN study reported non-inferiority of glycopyrronium 50mcg OD (GLY) vs tiotropium 18µg OD (TIO) when added to salmeterol/fluticasone 50/500mcg BID (SAL/FLU), and significant improvements in FEV1, health status and rescue medication for GLY+SAL/FLU vs SAL/FLU, in patients (pts) with COPD. (Frith P,et al.,ERJ 2014;44 Suppl 58) In this post-hoc analysis, efficacy [FEV1 & St George Respiratory Questionnaire (SGRQ) & rescue therapy] was assessed in different severity groups using baseline characteristics (GOLD 2014) to see whether benefits related to disease severity.This 12-wk multicentre blinded parallel group study randomised 773 pts to GLY+SAL/FLU (258), TIO+SAL/FLU (258) or SAL/FLU (257). Using baseline characteristics, pts were classified (post-hoc) into GOLD group A, B, C or D: n=121, 393, 27 and 229, respectively. A, B and D were analysed for changes in trough FEV1, SGRQ and rescue therapy.

Least square mean difference for GLY+SAL/FLU vs SAL/FLU (12 wks)

GOLD group	A	B	D
Trough FEV1 ml	124; p<0.001	88; p<0.001	97; p<0.001
SGRQ score	0.16; p=ns	-0.06; p=ns	-5.98; p<0.001
Rescue therapy daily puffs	-0.74; p=0.045	-0.49; p=ns	-1.11; p=0.007

 

Over 12 wks, the triple combination (GLY+SAL/FLU) showed significantly better improvements in lung function in pts in GOLD A, B and D; health status in GOLD D; and rescue therapy use in GOLD A and D, compared, to SAL/FLU. The results demonstrate significant benefits of GLY as add on therapy to SAL/FLU, not only in pts classified as GOLD group D (FEV1, SGRQ & rescue therapy), but also in less severe pts in other GOLD groups.


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Citations should be made in the following way:
Peter Frith (Daw Park, Australia), Peter Frith, Philip Thompson, Christina Frenzel, Nicol Kurstjens, GLISTEN Study Group. GLISTEN Study subanalysis: Glycopyrronium differentially improves lung function, health status and rescue medication use when added to salmeterol/fluticasone in COPD severity groups. Eur Respir J 2015; 46: Suppl. 59, 2955

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