Efficacy and Safety of Fluticasone Propionate(FP)/ Salmeterol Xinafoate (SLM) Hydro Fluoro Alkane (HFA) Metered Dose Inhaler (MDI) in Pediatric Patients With Bronchial Asthma

NCT02113436 | Completed Phase 4 Results

• 1 other identifier: 200860
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 69

Brief Summary

This study is a multicenter, stratified, randomized, active control, double-blinded, parallel-group comparative study with an open-label extension period. The study is designed to evaluate the efficacy and safety of FP/ SLM HFA MDI 50/25 microgram (mcg) one or two inhalation twice daily (BID) for 8 weeks in comparison with FP HFA MDI 50 mcg one or two inhalation BID, in 6-month to 4-year-old Japanese patients with bronchial asthma. The study is also designed to evaluate the safety of long-term treatment of FP/ SLM HFA MDI 50/25 mcg one or two BID for 16 weeks. The subjects meeting the eligibility criteria will enter the run-in period of 2 weeks and receive FP 50 mcg 1 or 2 inhalation bid (FP 100 or 200 mcg/day), before randomization. The subjects under 2 years of age at Visit 1 will receive only 1 inhalation bid during the run-in period. The subjects who meet the eligibility criteria for randomization will be stratified according to their age (\<2 or \>=2 year-old) at Visit 1 and randomized to one of the two treatment groups. The total duration of participation in the study will be 10 weeks for a comparison period completion and 27 weeks for a completion.

Conditions

Asthma

Keywords

FP/SLM; Asthma; Infant; Efficacy; Safety

Outcome Measures

Primary Outcomes (1)

• Mean Change From Baseline in Total Asthma Symptom Score (Daytime Plus Night Time) at the End of the Treatment Period 1 (TP1)

  The participant's parent or legally acceptable representative made entries asthma symptom experienced by the participant in a patient diary twice daily (day time and night time) in the form of scores on a 4-point rating scale from Baseline (Week -1) until end of TP1 (Week 8). Scores ranged from 0 to 3(0: one, 1: mild, 2: moderate, 3: severe) and maximum score is 6 per day. The Baseline value is a mean value of the last 7 consecutive days during the run-in period (excluding the day of Visit 2 \[Randomization\]). The end of the TP1 value is a mean value of the last 7 consecutive days during the TP1 (excluding the last day of the TP1). Change from Baseline is the difference between the value of the endpoint at the time point of interest and the Baseline value. Participants who completed TP1 and completed their diary were analyzed.

  Baseline and Week 8

Secondary Outcomes (7)

• Mean Change From Baseline in Night-time Asthma Symptoms Score at the End of Treatment Period 1 (TP1)

  Baseline and Week 8

• Mean Change From Baseline in Daytime Asthma Symptoms Score at the End of Treatment Period 1 (TP1)

  Baseline and Week 8

• Number of Participants With at Least One Asthma Exacerbation in Treatment Period 1 (TP1)

  Up to 8 weeks

• Mean Change From Baseline in Japanese Pediatric Asthma Control Program (JPAC) Score at the End of Treatment Period 1 (TP1)

  Baseline and Week 8

• Mean Change From Baseline in Use of Rescue Medication (Number of Occasions Used During a 24-hour Period) in Treatment Period 1 (TP1)

  Baseline and Week 8

Study Arms (2)

Fluticasone propionate (FP)/ Salmeterol xinafoate (SLM)

EXPERIMENTAL

Subject will receive 1 or 2 inhalation of SLM 25mcg plus FP 50mcg twice daily in the first treatment period for 8 weeks and will continue to receive SLM 25mcg plus FP 50mcg one or two inhalation twice daily for 16 weeks in the second treatment period.

Drug: FP/ SLM HFA MDI 50/25 mcg

Fluticasone propionate (FP)

ACTIVE COMPARATOR

Subject will receive 1 or 2 inhalation of FP 50mcg twice daily in the first treatment period for 8 weeks and will receive SLM 25mcg plus FP 50mcg one or two inhalation twice daily for 16 weeks in the second treatment period.

Drug: FP/ SLM HFA MDI 50/25 mcg; Drug: FP HFA MDI 50 mcg

Interventions

FP/ SLM HFA MDI 50/25 mcg DRUG

Metered-dose aerosol product containing 50 mcg of fluticasone propionate and 25 mcg of salmeterol per inhalation

Fluticasone propionate (FP); Fluticasone propionate (FP)/ Salmeterol xinafoate (SLM)

FP HFA MDI 50 mcg DRUG

Metered-dose aerosol product containing 50 mcg of fluticasone propionate per inhalation

Fluticasone propionate (FP)

Eligibility Criteria

• Age: 6 Months - 4 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• The written informed consent must be obtained from his/her parent or legally acceptable representative. If the investigator can get the oral consent from the patient, the investigator should record so in the informed consent which is signed by his/her parent or legally acceptable representative.
• Ethnic origin is Japanese
• Aged \>=6 months and \<=4 years at Visit 1.
• Male and pre-menarchial female. Pre-menarchial females are defined as any female who has yet to begin menses.
• Patient: outpatient
• Diagnosis as a pediatric asthma has been made by reference to JPGL 2012 and the document which is of help as evidence should be kept as source document. As for \<2 years old, children are going to be diagnosed according to an instruction as follows in JPGL2012 as a reference. There are 3 or more episodes of marked expiratory wheezing, regardless of the presence of respiratory tract infection. It is also needed to confirm that there is asymptomatic period for about a week between each episode. In addition to this finding, if there is at least one of following findings, it is more helpful to diagnose infantile asthma: At least one of parents is diagnosed with bronchial asthma by a physician (including past history); Specific immunoglobulin E (IgE) antibody for inhalation antigen is detected in at least one of parents; Diseased child is diagnosed with atopic dermatitis by a physician (including past history); Specific IgE antibody for inhalation antigen is detected in diseased child; High serum IgE level in diseased child or his/her family (serum IgE level should be determined by considering age); Eosinophils and creola bodies found in sputum (examine nasal discharge eosinophilia and peripheral blood eosinophilia); Expiratory wheezing occurs when there is no airway infection; Expiratory wheezing and labored respiration or oxygen saturation are improved after beta-2 stimulant inhalation.
• A patient who needs to be treated with Inhaled corticosteroid (ICS)/ Long-acting beta 2 agonist (LABA) and fulfill following all conditions: At least one documented exacerbation in that the patient treated with systemic glucocorticosteroids, aminophylline dose intravenous(d.i.v) or continuous isoproterenol inhalation in the 12 months prior to Visit 1. Or a well-documented regular treatment with ICS (FP 200-400 mcg daily or equivalent) continuous use in the 12 months prior to Visit 1; The patient has not received systemic glucocorticosteroids, aminophylline d.i.v., ICS (FP\>200 mcg daily or equivalent) or continuous isoproterenol inhalation within 4 weeks prior to Visit 1.

You may not qualify if:

• A patient who has suffered from upper and lower respiratory tract infection and then received medication within 2 weeks prior to Visit 1.
• A patient who is diagnosed upper and lower respiratory tract infection at Visit 1. Or a patient who has or is suspected to have deep-seated mycosis or infection to which no effective antibacterial agent is available. Or a patient who is suspected to have respiratory syncytial (RS) virus infection and cannot be identified to be negative for RS virus antigen.
• A patient who has respiratory disorder other than bronchial asthma, and the investigator judges the respiratory disorder affect the assessment of efficacy in this study.
• A patient who has unstable liver disease or chronic stable hepatitis B receiving significant immunosuppressive agents due to risk of hepatitis B reactivation.
• A patient who has malformation/foreign particle lodged in an airway. Or subjects who have known, pre-existing, clinically significant gastroesophageal reflux disease , endocrine, autoimmune, metabolic, neurological, renal, gastrointestinal, hepatic, haematological or any other system abnormalities that are uncontrolled with standard treatment.
• A patient who has or is suspected to have hypersensitivity to study medications, the rescue medication or any ingredients of them.
• A patient who has been treated with another investigational product within 1 months prior to Visit 1 or within five half-lives (t-half) of the prior investigational study (whichever is the longer of the two).
• As for the patients who has evaluable ECG data at Visit 1, QT interval corrected (Fridericia) for heart rate (QTc\[F\])\>=450 milliseconds (msec). The QT interval corrected for heart rate (QTc) should be based on averaged QTc values of triplicate electrocardiograms (ECGs) obtained over a brief recording period. As for the patients who don't has evaluable ECG data at Visit 1, if the patient has known prolonged QTc\>=450 msec (any correction is valid), the patient will be excluded.
• A patient who is child in care (including foster parent system), or whom the investigator judges inappropriate for the study.
• A patient who has asthma symptoms scores (total of daytime and night-time) both over \>=6 in total and \>=1 per day for \>=3 days at the last 7 consecutive days of the run-in period (excluding the day of Visit 2). Completion of symptom scores (daytime and night-time) on 5 or more days out of the last 7 consecutive days during the run-in period is required.
• A patient who has received systemic steroids during run-in period.
• A patient who has suffered from or is suspected to have upper and lower respiratory tract infection that may affect the assessment of the efficacy during the run-in period. Or a patient who has or is suspected to have deep-seated mycosis or infection to which no effective antibacterial agent is available during the run-in period. Or a patient who is suspected to have RS virus infection and cannot be identified to be negative for RS virus antigen during run-in period.
• A patient who has no evaluable ECG data during the run-in period. As for the patients who has evaluable ECG data during the run-in period, QTc(F) \>=450 msec. The QTc should be based on averaged QTc values of triplicate electrocardiograms (ECGs) obtained over a brief recording period.
• A patient who has not been able to appropriately record patient diary or inhale FP appropriately during the run-in period, in the opinion of the investigator.

Sponsors & Collaborators

• GlaxoSmithKline: lead

Study Sites (69)

GSK Investigational Site

Aichi, 451-0052, Japan

Location

GSK Investigational Site

Aichi, 470-1192, Japan

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GSK Investigational Site

Chiba, 260-0001, Japan

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GSK Investigational Site

Chiba, 273-0032, Japan

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GSK Investigational Site

Chiba, 284-0003, Japan

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GSK Investigational Site

Ehime, 790-8524, Japan

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GSK Investigational Site

Fukui, 910-0833, Japan

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GSK Investigational Site

Fukui, 910-8526, Japan

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GSK Investigational Site

Fukui, 918-8205, Japan

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GSK Investigational Site

Fukuoka, 802-8533, Japan

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GSK Investigational Site

Fukuoka, 811-1394, Japan

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GSK Investigational Site

Fukuoka, 811-3195, Japan

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GSK Investigational Site

Fukuoka, 813-0017, Japan

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GSK Investigational Site

Fukuoka, 814-0123, Japan

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GSK Investigational Site

Gifu, 500-8717, Japan

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GSK Investigational Site

Gunma, 370-0841, Japan

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GSK Investigational Site

Gunma, 372-0817, Japan

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GSK Investigational Site

Hiroshima, 720-8520, Japan

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GSK Investigational Site

Hiroshima, 730-0844, Japan

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GSK Investigational Site

Hiroshima, 730-8518, Japan

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GSK Investigational Site

Hiroshima, 734-0023, Japan

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GSK Investigational Site

Hiroshima, 737-0023, Japan

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GSK Investigational Site

Hiroshima, 738-8503, Japan

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GSK Investigational Site

Hokkaido, 006-0831, Japan

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GSK Investigational Site

Hokkaido, 064-0821, Japan

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GSK Investigational Site

Hokkaido, 069-0816, Japan

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GSK Investigational Site

Hokkaido, 070-0832, Japan

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GSK Investigational Site

Hokkaido, 070-8530, Japan

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GSK Investigational Site

Hokkaido, 078-8211, Japan

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GSK Investigational Site

Hokkaido, 078-8811, Japan

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GSK Investigational Site

Hyōgo, 650-0047, Japan

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GSK Investigational Site

Hyōgo, 653-0021, Japan

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GSK Investigational Site

Hyōgo, 674-0068, Japan

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GSK Investigational Site

Ibaraki, 300-0028, Japan

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GSK Investigational Site

Ibaraki, 302-0022, Japan

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GSK Investigational Site

Ibaraki, 312-0057, Japan

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GSK Investigational Site

Ishikawa, 920-8616, Japan

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GSK Investigational Site

Kagawa, 765-0033, Japan

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GSK Investigational Site

Kanagawa, 216-0006, Japan

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GSK Investigational Site

Kanagawa, 221-0014, Japan

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GSK Investigational Site

Kanagawa, 222-0012, Japan

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GSK Investigational Site

Kanagawa, 224-0001, Japan

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GSK Investigational Site

Kanagawa, 231-8682, Japan

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GSK Investigational Site

Kanagawa, 238-8567, Japan

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GSK Investigational Site

Kanagawa, 250-8558, Japan

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GSK Investigational Site

Kumamoto, 861-8520, Japan

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GSK Investigational Site

Mie, 514-0125, Japan

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GSK Investigational Site

Miyagi, 983-0816, Japan

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GSK Investigational Site

Okayama, 700-8607, Japan

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GSK Investigational Site

Osaka, 556-0005, Japan

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GSK Investigational Site

Osaka, 565-0862, Japan

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GSK Investigational Site

Osaka, 583-8588, Japan

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GSK Investigational Site

Saga, 840-8571, Japan

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GSK Investigational Site

Saitama, 344-0011, Japan

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GSK Investigational Site

Saitama, 351-0102, Japan

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GSK Investigational Site

Saitama, 360-0018, Japan

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GSK Investigational Site

Saitama, 360-0812, Japan

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GSK Investigational Site

Tochigi, 321-0293, Japan

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GSK Investigational Site

Tokyo, 152-0021, Japan

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GSK Investigational Site

Tokyo, 154-0002, Japan

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GSK Investigational Site

Tokyo, 154-0017, Japan

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GSK Investigational Site

Tokyo, 157-0066, Japan

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GSK Investigational Site

Tokyo, 158-0094, Japan

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GSK Investigational Site

Tokyo, 173-0015, Japan

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GSK Investigational Site

Tokyo, 176-0012, Japan

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GSK Investigational Site

Tokyo, 190-0023, Japan

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GSK Investigational Site

Tokyo, 196-0003, Japan

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GSK Investigational Site

Tokyo, 202-0004, Japan

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GSK Investigational Site

Wakayama, 646-8558, Japan

Location

Related Publications (1)

• Yoshihara S, Tsubaki T, Ikeda M, Lenney W, Tomiak R, Hattori T, Hashimoto K, Soutome T, Kato S. The efficacy and safety of fluticasone/salmeterol compared to fluticasone in children younger than four years of age. Pediatr Allergy Immunol. 2019 Mar;30(2):195-203. doi: 10.1111/pai.13010. Epub 2019 Feb 6.

  PMID: 30556939 DERIVED

MeSH Terms

Conditions

Asthma

Condition Hierarchy (Ancestors)

Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases

Results Point of Contact

• Title: GSK Response Center
• Organization: GlaxoSmithKline

866-435-7343

Study Officials

• GSK Clinical Trials

  GlaxoSmithKline

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 27, 2014
• First Posted: April 14, 2014
• Study Start: May 1, 2014
• Primary Completion: June 1, 2016
• Study Completion: October 1, 2016
• Last Updated: June 16, 2017
• Results First Posted: June 16, 2017

Record last verified: 2017-02

Locations

JP (69)