Trial Outcomes & Findings for Fluticasone Propionate/Salmeterol Combination 250/50 DISKUS in the Exercise Endurance Time in Patients With Chronic Obstructive Pulmonary Disease (NCT NCT01124422)

NCT ID: NCT01124422

Last Updated: 2017-11-08

Results Overview

EET is defined as the time taken by a participant to exert himself during an exercise. EET was calculated based on the Endurance Shuttle Walk test (ESWT). The ESWT is a standardized, externally controlled, constant-paced field test for the assessment of endurance capacity in participants with chronic lung disease. Change from Baseline in EET was calculated as the value at Week 8 minus the value at Baseline.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

255 participants

Primary outcome timeframe

Baseline (Week 3) and Week 8

Results posted on

2017-11-08

Participant Flow

In the open-label 4-week run-in phase, participants received 18 micrograms Tiotropium (TIO) once daily. Participants completing this phase (n=255) were then randomized to receive either TIO+placebo or TIO+Fluticasone propionate/salmeterol combination DISKUS. The number enrolled in the protocol section reflects these 255 randomized participants.

Participant milestones

Participant milestones
Measure
Tiotropium (TIO)
Tiotropium (TIO) was administered in the dose of 18 micrograms (mcg) once daily for a duration of 4 weeks
TIO+Placebo
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
4-Week Open-label Run-in Phase
STARTED
338
0
0
4-Week Open-label Run-in Phase
COMPLETED
255
0
0
4-Week Open-label Run-in Phase
NOT COMPLETED
83
0
0
4-Week Double-blind Treatment Phase
STARTED
0
131
124
4-Week Double-blind Treatment Phase
COMPLETED
0
120
115
4-Week Double-blind Treatment Phase
NOT COMPLETED
0
11
9

Reasons for withdrawal

Reasons for withdrawal
Measure
Tiotropium (TIO)
Tiotropium (TIO) was administered in the dose of 18 micrograms (mcg) once daily for a duration of 4 weeks
TIO+Placebo
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
4-Week Open-label Run-in Phase
Withdrawal by Subject
5
0
0
4-Week Open-label Run-in Phase
Adverse Event
7
0
0
4-Week Open-label Run-in Phase
Physician Decision
4
0
0
4-Week Open-label Run-in Phase
Lost to Follow-up
1
0
0
4-Week Open-label Run-in Phase
Did Not Meet Continuation Criteria
61
0
0
4-Week Open-label Run-in Phase
Protocol Violation
5
0
0
4-Week Double-blind Treatment Phase
Withdrawal by Subject
0
0
3
4-Week Double-blind Treatment Phase
Adverse Event
0
6
3
4-Week Double-blind Treatment Phase
Physician Decision
0
5
2
4-Week Double-blind Treatment Phase
Lost to Follow-up
0
0
1

Baseline Characteristics

Fluticasone Propionate/Salmeterol Combination 250/50 DISKUS in the Exercise Endurance Time in Patients With Chronic Obstructive Pulmonary Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TIO+Placebo
n=131 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=124 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Total
n=255 Participants
Total of all reporting groups
Age, Continuous
62.9 Years
STANDARD_DEVIATION 9.85 • n=5 Participants
62.5 Years
STANDARD_DEVIATION 8.94 • n=7 Participants
62.7 Years
STANDARD_DEVIATION 9.41 • n=5 Participants
Sex: Female, Male
Female
61 Participants
n=5 Participants
54 Participants
n=7 Participants
115 Participants
n=5 Participants
Sex: Female, Male
Male
70 Participants
n=5 Participants
70 Participants
n=7 Participants
140 Participants
n=5 Participants
Race/Ethnicity, Customized
African American/African Heritage
4 participants
n=5 Participants
10 participants
n=7 Participants
14 participants
n=5 Participants
Race/Ethnicity, Customized
Japanese/East Asian Heritage/South East Asian
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Race/Ethnicity, Customized
White
126 participants
n=5 Participants
110 participants
n=7 Participants
236 participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native and White
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: Intent-to-Treat (ITT) Population: all participants randomized to study drug. Only those participants contributing data at the indicated time points were analyzed.

EET is defined as the time taken by a participant to exert himself during an exercise. EET was calculated based on the Endurance Shuttle Walk test (ESWT). The ESWT is a standardized, externally controlled, constant-paced field test for the assessment of endurance capacity in participants with chronic lung disease. Change from Baseline in EET was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=122 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=115 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Exercise Endurance Time (EET) From Baseline (Week 3) to Week 8
23.3 Seconds (sec)
Standard Error 15.5
6.0 Seconds (sec)
Standard Error 16.2

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

EDS is used to measure the level of breathlessness due to exercise, assessed using a 10-point modified Borg scale at 2-minute intervals during the ESWT: 0=no difficulty in breathing at all, 10=maximal breathing difficulty (BD). The participant pointed to the level on the scale correlating with his BD, and the local study coordinator confirmed that level verbally to him. Change from Baseline was calculated as the value at Week 8 minus the value at Baseline. A dyspnea score/time slope was calculated by fitting a linear regression line to the dyspnea scores reported during the exercise tests.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=121 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=110 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Scores on the Exercise Dyspnea Scale (EDS) From Baseline (Week 3) to Week 8
-0.1 Scores on a scale/minute
Standard Error 0.055
-0.06 Scores on a scale/minute
Standard Error 0.058

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

EDS at isotime (last common time point for an exercise assessment \[i.e., last Borg score time point of the shortest exercise test for each participant\]) was assessed using a 10-point modified Borg scale. Change from Baseline in EDS at isotime was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=121 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=110 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in EDS at Isotime From Baseline (Week 3) to Week 8
-0.3 Scores on a scale
Standard Error 0.2
-0.5 Scores on a scale
Standard Error 0.2

SECONDARY outcome

Timeframe: Baseline (Week 4) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

Resting IC is the volume of gas that can be taken into the lungs in a full inhalation at the resting position. The resting IC was measured before and after dosing. Change from Baseline in pre-dose resting IC was calculated as the pre-dose value at Week 8 minus the pre-dose value at Week 4. Change from Baseline in post-dose resting IC was calculated as the post-dose value at Week 8 minus the pre-dose value at Week 4.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=122 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=115 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Pre-dose and Post-dose Resting Inspiratory Capacity (IC) From Baseline (Week 4) to Week 8
Pre-dose
-29 Milliliters (mL)
Standard Error 29
60 Milliliters (mL)
Standard Error 31.2
Mean Change in Pre-dose and Post-dose Resting Inspiratory Capacity (IC) From Baseline (Week 4) to Week 8
Post-dose
73 Milliliters (mL)
Standard Error 29.6
167 Milliliters (mL)
Standard Error 31.4

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

EIC is the volume of gas that can be taken into the lungs in a full inhalation during exercise. Participants were asked to undergo the IC test every 2 minutes during exercise and at the end of the exercise, to follow changes in operational lung volumes that occured in association with exercise. Change from Baseline in EIC was calculated as the value at the end of exercise at Week 8 minus the value at the end of exercise at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=38 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=29 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Exercise Inspiratory Capacity (EIC) at the End of Exercise From Baseline (Week 3) to Week 8
-7.4 mL
Standard Error 120
46.6 mL
Standard Error 93.3

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The V'O2 was measured during the ESWT using the Oxycon Mobile System (OMS), a portable telemetric monitoring system consisting of an oxygen sensor allowing for breath-by-breath measurement of gas exchange parameters in the lungs. The V'O2 was collected in units of mL and then regressed over the conduct of the exercise test measured in minutes. The V'O2 per time slope was calculated for each participant (par.) by fitting a linear regression line to the V'O2 recorded for each par. during the ESWT. V'O2 per time slope results were compared between treatment groups as means of these regression lin

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=41 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=32 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Flow of Oxygen (V'O2) Per Time Slope During the Course of the ESWT From Baseline (Week 3) to Week 8
-13.3 mL/minute (min)
Standard Error 10.36
-6.1 mL/minute (min)
Standard Error 14.89

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The amount of CO2 in the hemoglobin of the participants was measured during the ESWT using the OMS. The system consisted of a carbon dioxide sensor and allowed breath-by-breath measurement of pulmonary gas exchange parameters. The V'CO2 per time slope was calculated for each participant by fitting a linear regression line to the V'CO2 recorded for each participant during the ESWT. V'CO2 per time slope results were compared between treatment groups as means of these regression lines. Change from Baseline in V'CO2 per time slope was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=41 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=31 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Flow of Carbon Dioxide (V'CO2) Per Time Slope During the Course of the ESWT From Baseline (Week 3) to Week 8
-17.4 mL/min
Standard Error 10.36
-0.7 mL/min
Standard Error 11.96

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The V'E was measured in the participants during the ESWT using the OMS. The system consisted of a volume transducer, oxygen sensor, and carbon dioxide sensor and allowed breath-by-breath measurement of pulmonary gas exchange parameters. The V'E was collected in liters and then regressed over the conduct of the exercise test measured in minutes. The V'E per time slope was calculated for each participant by fitting a linear regression line to the V'E recorded for each participant during the ESWT. V'E per time slope results were compared between treatment groups as means of the regression lines.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Minute Ventilation (V'E) Per Time Slope During the Course of the ESWT From Baseline (Week 3) to Week 8
-0.7 Liter (L)/min
Standard Error 0.35
-0.2 Liter (L)/min
Standard Error 0.49

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

HR is defined as the number of heartbeats per unit of time, typically expressed as beats per minute (bpm). It was measured during the ESWT using the OMS. The HR was collected in units of bpm and then regressed over the conduct of the exercise test measured in minutes. The HR per time slope was calculated for each participant by fitting a linear regression line to the HR recorded for each participant during the exercise test. HR per time slope results were compared between treatment groups as means of these regression lines.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Heart Rate (HR) Per Time Slope During the Course of the ESWT From Baseline (Week 3) to Week 8
-1.1 bpm/min
Standard Error 0.70
0.7 bpm/min
Standard Error 0.80

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The respiratory exchange ratio was calculated as the ratio of VCO2 and VO2. The ratio of the amount of carbon dioxide and oxygen in the hemoglobin of the participants was measured during the ESWT using the OMS. The system consisted of oxygen and carbon dioxide sensors and allowed breath-by-breath measurement of pulmonary gas exchange parameters. Change from Baseline in RER was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Respiratory Exchange Ratio (RER) Per Time Slope During the Course of the ESWT From Baseline to Week 8
-0.01 Ratio of VCO2 and VO2
Standard Error 0.004
0.01 Ratio of VCO2 and VO2
Standard Error 0.007

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

RR is defined as the number of breaths taken within a set amount of time (typically within 60 secs). The RR of the participants was measured during the ESWT using the OMS. The system consisted of volume transducer oxygen and carbon dioxide sensors and allowed breath-by-breath measurement of pulmonary gas exchange parameters. The RR per time slope was calculated for each participant by fitting a linear regression line to the RR recorded for each participant during the ESWT. RR per time slope results were compared between treatment groups as means of these regression lines.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Respiratory Rate (RR) Per Time Slope During the Course of the ESWT From Baseline (Week 3) to Week 8
-0.1 breaths/min/min
Standard Error 0.18
-0.5 breaths/min/min
Standard Error 0.44

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

RR is defined as the number of breaths taken within a set amount of time (typically within 60 secs). The RR of the participants at isotime was measured during the ESWT using the OMS. Change from Baseline in RR at isotime was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Respiratory Rate (RR) at Isotime During the Course of the ESWT From Baseline to Week 8
0.8 breaths/min
Standard Error 0.71
-0.5 breaths/min
Standard Error 0.68

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

VT is the lung volume representing the normal volume of air displaced between normal inspiration and expiration when extra effort is not applied (normal value is approximately 500 mL or 7 mL/kg body weight). VT was measured during the ESWT using the OMS, consisting of volume transducer O2 and CO2 sensors and allowing breath-by-breath measurement of pulmonary gas exchange parameters. The participant's VT per time slope was calculated by fitting a linear regression line (RL) to their VT during the ESWT. VT per time slope results were compared between treatment groups as means of these RLs.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Tidal Volume (VT) Per Time Slope During the Course of the ESWT From Baseline to Week 8
-0.02 L/min
Standard Error 0.008
0 L/min
Standard Error 0.014

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

VT is defined as the lung volume representing the normal volume of air displaced between normal inspiration and expiration when extra effort is not applied. The normal value is approximately 500 mL or 7 mL/kg body weight. The VT of the participants at isotime was measured during the ESWT using the OMS. Change from Baseline in VT at isotime was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Tidal Volume (VT) at Isotime During the Course of the ESWT From Baseline to Week 8
-0.10 L
Standard Error 0.04
0.08 L
Standard Error 0.042

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed. A subgroup of participants specified sites provided cardio-respiratory and exercise IC measurements with the Oxycon Mobile System (OMS). Participants not at these sites formed the non-OMS subgroup.

HR was measured during the course of the ESWT in the non-OMS subgroup using pulse oximetry. The HR per time slope was calculated for each participant by fitting a linear regression line to the HR recorded for each participant during the ESWT. HR per time slope results were compared between treatment groups as means of these regression lines. Change from Baseline in HR was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=72 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=76 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in HR Per Time Slope During the Course of the ESWT Using Pulse Oximetry From Baseline to Week 8 (Non-OMS Subgroup)
-0.8 bpm/min
Standard Error 0.55
-0.6 bpm/min
Standard Error 0.56

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The RR and VT of the participants at isotime were measured during the ESWT using the OMS. The ratio of RR per VT (value of RR divided by value of VT) at isotime was calculated. Change from Baseline in RR/VT at isotime was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=42 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=34 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Ratio of Respiratory Rate (RR) to Tidal Volume (VT) or RR/VT at Isotime During the Course of the ESWT From Baseline to Week 8
2.7 breaths/min/L
Standard Error 1.14
-2.5 breaths/min/L
Standard Error 1.27

SECONDARY outcome

Timeframe: Baseline (Week 3) and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The EIC was measured at 2 to 3.5 minutes during the exercise period. Change from Baseline in EIC was calculated as the value at Week 8 minus the value at Baseline.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=24 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=22 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in EIC at 2 to 3.5 Minutes During the Exercise Period From Baseline (Week 3) to Week 8
-148.3 mL
Standard Error 118.7
200 mL
Standard Error 110.2

SECONDARY outcome

Timeframe: Week 4 and Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The CRQ-SAS, a self-administered tool used to assess health-related quality-of-life (HRQOL), consists of 20 questions (q.) in 4 domains: Dyspnea (5 q.), Fatigue (4 q.), Emotional Function (7 q.), and Mastery (4 q.). Participants rated their experience on a 7-point scale in response to each q.: 1 (maximum impairment) to 7 (no impairment); higher scores indicate better HRQOL. Individual q. were equally weighted, and domain scores (range=1-7) were calculated as the mean across the non-missing items within each domain (domain scores were calculated although an individual item score was missing).

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=122 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=115 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Mean Change in Scores on the Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS) Questionnaire From Week 4 to Week 8
Mastery Score
0.07 Scores on a scale
Standard Error 0.08
0.09 Scores on a scale
Standard Error 0.1
Mean Change in Scores on the Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS) Questionnaire From Week 4 to Week 8
Dyspnea Score
0.21 Scores on a scale
Standard Error 0.09
0.32 Scores on a scale
Standard Error 0.1
Mean Change in Scores on the Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS) Questionnaire From Week 4 to Week 8
Fatigue Score
0.11 Scores on a scale
Standard Error 0.08
0.26 Scores on a scale
Standard Error 0.1
Mean Change in Scores on the Chronic Respiratory Disease Questionnaire Self-Administered Standardized (CRQ-SAS) Questionnaire From Week 4 to Week 8
Emotional Function Score
0.10 Scores on a scale
Standard Error 0.07
0.13 Scores on a scale
Standard Error 0.08

SECONDARY outcome

Timeframe: BDI: Week 4; TDI: Week 8

Population: ITT Population. Only those participants contributing data at the indicated time points were analyzed.

The BDI-TDI is a multidimensional dyspnea measurement. The BDI, administered at Week 4, consisted of 3 items (functional impairment, magnitude of task in exertional capacity, and magnitude of effort) requiring recall over the previous 4 weeks. BDI scores ranged from 0 (very severe impairment) to 4 (no impairment); the summed total score = 0 to 12. The TDI, administered at Week 8 as a follow-up of the BDI, consisted of the same 3 items requiring recall over the previous 4 weeks. TDI scores ranged from -3 (major deterioration) to +3 (major improvement); the summed total score = -9 to 9.

Outcome measures

Outcome measures
Measure
TIO+Placebo
n=130 Participants
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=122 Participants
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Baseline Dyspnea Index (BDI) at Week 4 and Transition Dyspnea Index (TDI) at Week 8
BDI; n=130; 122
6.7 Scores on a scale
Standard Error 0.20
6.9 Scores on a scale
Standard Error 0.22
Baseline Dyspnea Index (BDI) at Week 4 and Transition Dyspnea Index (TDI) at Week 8
TDI; n=121, 115
1.1 Scores on a scale
Standard Error 0.2
1.4 Scores on a scale
Standard Error 0.2

Adverse Events

TIO+Placebo

Serious events: 3 serious events
Other events: 18 other events
Deaths: 0 deaths

TIO+FSC

Serious events: 0 serious events
Other events: 22 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
TIO+Placebo
n=131 participants at risk
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=124 participants at risk
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
1.5%
2/131
0.00%
0/124
Cardiac disorders
Acute myocardial infarction
0.76%
1/131
0.00%
0/124

Other adverse events

Other adverse events
Measure
TIO+Placebo
n=131 participants at risk
Matching placebo DISKUS twice daily (BD) plus tiotropium 18 mcg once daily for a duration of 4 weeks
TIO+FSC
n=124 participants at risk
Fluticasone propionate/salmeterol combination (FSC) DISKUS, administered in the dose of 250/50 mcg BD, plus tiotropium in the dose of 18 mcg once daily for a duration of 4 weeks
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
2.3%
3/131
0.81%
1/124
Respiratory, thoracic and mediastinal disorders
Cough
0.76%
1/131
1.6%
2/124
Respiratory, thoracic and mediastinal disorders
Dsyphonia
0.00%
0/131
1.6%
2/124
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
0.76%
1/131
0.81%
1/124
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.76%
1/131
0.00%
0/124
Respiratory, thoracic and mediastinal disorders
Nasal congestion
0.00%
0/131
0.81%
1/124
Respiratory, thoracic and mediastinal disorders
Pulmonary congestion
0.00%
0/131
0.81%
1/124
Musculoskeletal and connective tissue disorders
Arthralgia
1.5%
2/131
0.81%
1/124
Musculoskeletal and connective tissue disorders
Muscle spasms
0.00%
0/131
2.4%
3/124
Musculoskeletal and connective tissue disorders
Back pain
0.76%
1/131
0.00%
0/124
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
0.76%
1/131
0.00%
0/124
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/131
0.81%
1/124
Musculoskeletal and connective tissue disorders
Neck pain
0.00%
0/131
0.81%
1/124
Gastrointestinal disorders
Dyspepsia
0.00%
0/131
2.4%
3/124
Gastrointestinal disorders
Dry mouth
0.00%
0/131
1.6%
2/124
Gastrointestinal disorders
Abdominal pain upper
0.00%
0/131
0.81%
1/124
Gastrointestinal disorders
Chapped lips
0.76%
1/131
0.00%
0/124
Gastrointestinal disorders
Diarrhoea
0.76%
1/131
0.00%
0/124
Gastrointestinal disorders
Gastroesophageal reflux disease
0.76%
1/131
0.00%
0/124
Infections and infestations
Nasopharyngitis
0.76%
1/131
1.6%
2/124
Infections and infestations
Bronchitis
0.00%
0/131
1.6%
2/124
Infections and infestations
Acute sinusitis
0.00%
0/131
0.81%
1/124
Infections and infestations
Cellulitis
0.00%
0/131
0.81%
1/124
Infections and infestations
Labyrinthitis
0.00%
0/131
0.81%
1/124
Infections and infestations
Oral herpes
0.76%
1/131
0.00%
0/124
Injury, poisoning and procedural complications
Contusion
0.76%
1/131
0.81%
1/124
Injury, poisoning and procedural complications
Fall
0.00%
0/131
0.81%
1/124
Injury, poisoning and procedural complications
Foot fracture
0.76%
1/131
0.00%
0/124
Injury, poisoning and procedural complications
Joint injury
0.76%
1/131
0.00%
0/124
Injury, poisoning and procedural complications
Skeletal injury
0.76%
1/131
0.00%
0/124
Injury, poisoning and procedural complications
Soft tissue injury
0.76%
1/131
0.00%
0/124
Cardiac disorders
Arrhythmia
0.00%
0/131
0.81%
1/124
Cardiac disorders
Coronary artery disease
0.76%
1/131
0.00%
0/124
Eye disorders
Conjunctivitis
0.00%
0/131
0.81%
1/124
Eye disorders
Eye pain
0.76%
1/131
0.00%
0/124
Psychiatric disorders
Depression
0.00%
0/131
0.81%
1/124
Psychiatric disorders
Insomnia
0.76%
1/131
0.00%
0/124
Skin and subcutaneous tissue disorders
Actinic keratosis
0.76%
1/131
0.00%
0/124
Skin and subcutaneous tissue disorders
Pruritus
0.00%
0/131
0.81%
1/124
General disorders
Chest discomfort
0.76%
1/131
0.00%
0/124
Metabolism and nutrition disorders
Hyperlipidemia
0.76%
1/131
0.00%
0/124
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Squamous cell carcinoma
0.76%
1/131
0.00%
0/124
Nervous system disorders
Migraine
0.00%
0/131
0.81%
1/124

Additional Information

GSK Response Center

GlaxoSmithKline

Phone: 866-435-7343

Results disclosure agreements

  • Principal investigator is a sponsor employee GSK agreements may vary with individual investigators, but will not prohibit any investigator from publishing. GSK supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.
  • Publication restrictions are in place

Restriction type: OTHER