Comparative Effects of Triple Inhaled Therapy With Budesonide/Glycopyrronium/Formoterol Versus Fluticasone Furoate/Umeclidinium/Vilanterol on Small Airway Disease in COPD Patients: A Randomized Crossover Study

NCT ID: NCT06905483

Last Updated: 2025-04-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

28 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-01

Study Completion Date

2026-03-31

Brief Summary

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The goal of this clinical trial is to determine if triple inhaled therapy with Budesonide/Glycopyrronium/Formoterol (BGF) and Fluticasone Furoate/Umeclidinium/Vilanterol (FUV) are effective in treating patients with stable chronic obstructive pulmonary disease (COPD). It will also assess the safety of both drugs.

The main questions it aims to answer are:

* Does BGF demonstrate a comparable effect to FUV in COPD participants?
* What medical problems do participants experience when taking BGFand FUV?

Detailed Description

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This study is a randomized crossover study. COPD patients aged 40 years or older with stable disease are included. Each patient receives four weeks of treatment with either BGF or FUV followed by a one-week washout period, and then four weeks of treatment with the other drug. Respiratory symptoms are assessed using modified Medical Research Council (mMRC) dyspnea scale and COPD Assessment Test (CAT). Pulmonary function is assessed by spirometry with bronchodilator testing, and adverse events were recorded. Spirometry data, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory flow at 25-75% of FVC (FEF25-75) are also collected. Impulse oscillometry (IOS) is also performed, with results reported as R5, R20, R5-R20, X5, Fres, and Ax.

Conditions

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COPD Chronic Obstructive Pulmonary Disease (COPD) Small Airway Disease Triple Therapy Lung Function

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This study is a randomized crossover study. COPD patients aged 40 years or older with stable disease are included. Each patient receives four weeks of treatment with either BGF or FUV followed by a one-week washout period, and then four weeks of treatment with the other drug. Respiratory symptoms, pulmonary function, and safety are assessed.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Budesonide/Glycopyrronium/Formoterol (BGF)

BGF (160/7.2/5 mcg) 2 inhalations, twice daily for 4 weeks

Group Type EXPERIMENTAL

Budesonide/Glycopyrronium/Formoterol (BGF)

Intervention Type DRUG

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Fluticasone Furoate/Umeclidinium/Vilanterol (FUV)

Intervention Type DRUG

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Fluticasone Furoate/Umeclidinium/Vilanterol (FUV)

FUV (100/62.5/25 mcg) 1 inhalation, once daily for 4 weeks

Group Type ACTIVE_COMPARATOR

Budesonide/Glycopyrronium/Formoterol (BGF)

Intervention Type DRUG

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Fluticasone Furoate/Umeclidinium/Vilanterol (FUV)

Intervention Type DRUG

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Interventions

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Budesonide/Glycopyrronium/Formoterol (BGF)

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Intervention Type DRUG

Fluticasone Furoate/Umeclidinium/Vilanterol (FUV)

Each patient received 4 weeks of treatment with either BGF or FUV followed by a 1-week washout period, and then 4 weeks of treatment with the other drug.

Intervention Type DRUG

Other Intervention Names

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Breztri Trelegy

Eligibility Criteria

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Inclusion Criteria

* COPD diagnosis confirmed by spirometry (post-bronchodilator FEV1/FVC \< 70%)
* Aged 40-80 years
* Smoking 10 pack-years or more
* Postbronchodilator FEV1 \< 80%

Exclusion Criteria

* History of COPD exacerbation within 3 months
* Asthma, bronchiectasis, pulmonary fibrosis
* Inability to perform spirometry, impulse oscillometry, or 6-minute walk test
* Pregnant or breastfeeding women
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Thammasat University

OTHER

Sponsor Role lead

Responsible Party

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Narongkorn Saiphoklang, MD

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Narongkorn Saiphoklang, MD

Role: PRINCIPAL_INVESTIGATOR

Thammasat University Faculty of Medicine

Locations

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Narongkorn Saiphoklang

Pathum Thani, Changwat Pathum Thani, Thailand

Site Status RECRUITING

Countries

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Thailand

Central Contacts

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Narongkorn Saiphoklang, MD

Role: CONTACT

+6629269794

Peerawat Kaewkeeyoon, MD

Role: CONTACT

+6629269794

Facility Contacts

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Narongkorn Saiphoklang, MD

Role: primary

+6629269794

Peerawat Kaewkeeyoon, MD

Role: backup

+6629269794

References

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Usmani O, Li G, De Backer J, Sadafi H, Wu L, Marshall J. Modeled small airways lung deposition of two fixed-dose triple therapy combinations assessed with in silico functional respiratory imaging. Respir Res. 2023 Sep 23;24(1):226. doi: 10.1186/s12931-023-02534-y.

Reference Type BACKGROUND
PMID: 37742015 (View on PubMed)

Usmani OS, Scichilone N, Mignot B, Belmans D, Van Holsbeke C, De Backer J, De Maria R, Cuoghi E, Topole E, Georges G. Airway Deposition of Extrafine Inhaled Triple Therapy in Patients with COPD: A Model Approach Based on Functional Respiratory Imaging Computer Simulations. Int J Chron Obstruct Pulmon Dis. 2020 Oct 7;15:2433-2440. doi: 10.2147/COPD.S269001. eCollection 2020.

Reference Type BACKGROUND
PMID: 33116458 (View on PubMed)

Bremner PR, Birk R, Brealey N, Ismaila AS, Zhu CQ, Lipson DA. Single-inhaler fluticasone furoate/umeclidinium/vilanterol versus fluticasone furoate/vilanterol plus umeclidinium using two inhalers for chronic obstructive pulmonary disease: a randomized non-inferiority study. Respir Res. 2018 Jan 25;19(1):19. doi: 10.1186/s12931-018-0724-0.

Reference Type BACKGROUND
PMID: 29370819 (View on PubMed)

Bansal S, Anderson M, Anzueto A, Brown N, Compton C, Corbridge TC, Erb D, Harvey C, Kaisermann MC, Kaye M, Lipson DA, Martin N, Zhu CQ, Papi A. Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus tiotropium monotherapy in patients with COPD. NPJ Prim Care Respir Med. 2021 May 25;31(1):29. doi: 10.1038/s41533-021-00241-z.

Reference Type BACKGROUND
PMID: 34035312 (View on PubMed)

Lipson DA, Barnacle H, Birk R, Brealey N, Locantore N, Lomas DA, Ludwig-Sengpiel A, Mohindra R, Tabberer M, Zhu CQ, Pascoe SJ. FULFIL Trial: Once-Daily Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2017 Aug 15;196(4):438-446. doi: 10.1164/rccm.201703-0449OC.

Reference Type BACKGROUND
PMID: 28375647 (View on PubMed)

Maneechotesuwan K, Sawatdee S, Srichana T. In Vitro Analysis of Aerodynamic Properties and Co-Deposition of a Fixed-Dose Combination of Fluticasone Furoate, Umeclidinium Bromide, and Vilanterol Trifenatate. Pharmaceutics. 2024 Oct 18;16(10):1334. doi: 10.3390/pharmaceutics16101334.

Reference Type BACKGROUND
PMID: 39458663 (View on PubMed)

Martinez FJ, Rabe KF, Ferguson GT, Wedzicha JA, Trivedi R, Jenkins M, Darken P, Aurivillius M, Dorinsky P. Benefits of budesonide/glycopyrrolate/formoterol fumarate (BGF) on symptoms and quality of life in patients with COPD in the ETHOS trial. Respir Med. 2021 Aug-Sep;185:106509. doi: 10.1016/j.rmed.2021.106509. Epub 2021 Jun 18.

Reference Type BACKGROUND
PMID: 34171789 (View on PubMed)

Ishiura Y, Fujimura M, Ohkura N, Hara J, Kasahara K, Ishii N, Sawai Y, Shimizu T, Tamaki T, Nomura S. Triple Therapy with Budesonide/Glycopyrrolate/Formoterol Fumarate Improves Inspiratory Capacity in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap. Int J Chron Obstruct Pulmon Dis. 2020 Feb 5;15:269-277. doi: 10.2147/COPD.S231004. eCollection 2020.

Reference Type BACKGROUND
PMID: 32103926 (View on PubMed)

Rabe KF, Martinez FJ, Singh D, Trivedi R, Jenkins M, Darken P, Aurivillius M, Dorinsky P. Improvements in lung function with budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler versus dual therapies in patients with COPD: a sub-study of the ETHOS trial. Ther Adv Respir Dis. 2021 Jan-Dec;15:17534666211034329. doi: 10.1177/17534666211034329.

Reference Type BACKGROUND
PMID: 34428980 (View on PubMed)

Ferguson GT, Rabe KF, Martinez FJ, Fabbri LM, Wang C, Ichinose M, Bourne E, Ballal S, Darken P, DeAngelis K, Aurivillius M, Dorinsky P, Reisner C. Triple therapy with budesonide/glycopyrrolate/formoterol fumarate with co-suspension delivery technology versus dual therapies in chronic obstructive pulmonary disease (KRONOS): a double-blind, parallel-group, multicentre, phase 3 randomised controlled trial. Lancet Respir Med. 2018 Oct;6(10):747-758. doi: 10.1016/S2213-2600(18)30327-8. Epub 2018 Sep 16.

Reference Type BACKGROUND
PMID: 30232048 (View on PubMed)

Usmani O, Roche N, Wahab E, Israel S, Jenkins M, Trivedi R, Dorinsky P, Aurivillius M. A scintigraphy study of budesonide/glycopyrrolate/formoterol fumarate metered dose inhaler in patients with moderate-to-very severe chronic obstructive pulmonary disease. Respir Res. 2021 Oct 7;22(1):261. doi: 10.1186/s12931-021-01813-w.

Reference Type BACKGROUND
PMID: 34620167 (View on PubMed)

Bickel S, Popler J, Lesnick B, Eid N. Impulse oscillometry: interpretation and practical applications. Chest. 2014 Sep;146(3):841-847. doi: 10.1378/chest.13-1875.

Reference Type BACKGROUND
PMID: 25180727 (View on PubMed)

McNulty W, Usmani OS. Techniques of assessing small airways dysfunction. Eur Clin Respir J. 2014 Oct 17;1. doi: 10.3402/ecrj.v1.25898. eCollection 2014.

Reference Type BACKGROUND
PMID: 26557240 (View on PubMed)

Lazarinis N, Fouka E, Linden A, Bossios A. Small airways disease in chronic obstructive pulmonary disease. Expert Rev Respir Med. 2024 Jul;18(7):539-552. doi: 10.1080/17476348.2024.2380070. Epub 2024 Jul 24.

Reference Type BACKGROUND
PMID: 39046133 (View on PubMed)

Singh D, Long G, Cancado JED, Higham A. Small airway disease in chronic obstructive pulmonary disease: insights and implications for the clinician. Curr Opin Pulm Med. 2020 Mar;26(2):162-168. doi: 10.1097/MCP.0000000000000637.

Reference Type BACKGROUND
PMID: 31688242 (View on PubMed)

Verleden SE, Hendriks JMH, Snoeckx A, Mai C, Mentens Y, Callebaut W, De Belie B, Van Schil PE, Verplancke V, Janssens A, Jacob J, Pakzad A, Conlon TM, Guvenc G, Yildirim AO, Pauwels P, Koljenovic S, Kwakkel-Van Erp JM, Lapperre TS. Small Airway Disease in Pre-Chronic Obstructive Pulmonary Disease with Emphysema: A Cross-Sectional Study. Am J Respir Crit Care Med. 2024 Mar 15;209(6):683-692. doi: 10.1164/rccm.202301-0132OC.

Reference Type BACKGROUND
PMID: 38055196 (View on PubMed)

Sudi A, Santa B, Horvath A, Tomisa G, Abonyi-Toth Z, Rokszin G, Eszes N, Muller V, Tamasi L. The Real-World Efficacy of Fixed Triple Inhalation Therapy in the Treatment of Moderate COPD Patients (RATIONALE Study). Int J Chron Obstruct Pulmon Dis. 2024 Aug 28;19:1943-1955. doi: 10.2147/COPD.S474354. eCollection 2024.

Reference Type BACKGROUND
PMID: 39219564 (View on PubMed)

Other Identifiers

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MTU-EC-IM-5-271/67

Identifier Type: -

Identifier Source: org_study_id

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