P127 Superiority of glycopyrronium versus tiotropium in early onset of bronchodilation in patients with moderate to severe COPD – the FAST study. (12th November 2015)

• Record Type: Journal Article
• Authors: Watz, H; Mailaender, C; Kirsten, A-M
• Is Part Of: Thorax. Volume 70(2015)Supplement 3
• Page Start: A140
• Page End: A140
• Publication Date: 2015-11-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thoraxjnl-2015-207770.264
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: Glycopyrronium (GLY) has demonstrated efficacy similar to open-label and single-blinded tiotropium (TIO) in the treatment of COPD and fast onset of bronchodilation action. 1, 2 The double-blinded FAST study compared the efficacy of GLY with TIO in serial spirometry and bodyplethysmography measurements to allow for a more intensified characterisation of the earlier onset of action. Methods: In this multicenter, randomised, double-blinded, double-dummy, cross-over study patients (pts) with moderate-to-severe COPD received single-dose of both once- daily GLY 44 μg and TIO 18 μg via the Breezhaler® and Handihaler® devices respectively. Primary endpoint was the forced expiratory volume in one second (FEV1 ) AUC –2h . Other endpoints included inspiratory capacity (IC), residual volume (RV), functional residual capacity (FRC) and specific airway resistance (sRaw), all measured by bodyplethysmography. Results: Of 152 pts randomised (mean age: 61.8 yr, mean post-bronchodilator FEV1 : 52.1%) 99.3% completed the study. After inhalation of the single dose, GLY demonstrated superiority to TIO in early bronchodilation i.e. FEV1 AUC –2h (least squares mean (LSM) = 0.037 L, p = 0.0006). Both treatments showed similar improvements in IC, RV, and FRCpleth. Over the first 90 min after dosing, GLY also showed statistically significant improvement in sRaw compared to TIO with a difference of 0, 184 kPa*s at the time point 90 min (LSM, p = 0.006). Conclusion: GLY showed effective bronchodilation and was superior to double-blinded TIO in terms of early onset of bronchodilation. Both GLY and TIO showed similar improvements in static lung volume parameters; however GLY was superior in reduction of sRaw early after inhalation. References: 1 Kerwin E, et al . Eur Resp J 2012;40 :1106–1114 2 Chapman, et al . BMC Pulm Med . 2014 ;14:4