BMC Pulmonary Medicine · 2016 · 14 citations · 6 references
MedicinePharmacokineticsPharmacologyClinical PharmacologyPharmacodynamicsPulmonary Function TestingBronchodilator TherapyChronic Obstructive Pulmonary DiseaseChronic Obstructive Pulmonary Disease PharmacotherapyObstructive Lung DiseasePulmonary PharmacokineticsRespiratory PharmacologyActive Comparator DesignActive Comparator TrialsBeta2-adrenergic Agonist TherapyBronchodilator SafetyChronic Obstructive Pulmonary Disease BronchodilationLong-acting Beta AgonistsLong-acting Beta2-agonistsLong-acting Bronchodilator Therapy
BACKGROUND: Abediterol is a novel, once-daily long-acting β2-agonist in development for the treatment of chronic obstructive pulmonary disease (COPD) and asthma in combination with an anti-inflammatory agent. This Phase IIa, randomised, double-blind, crossover study investigated the bronchodilation, safety, tolerability and pharmacokinetics of abediterol in patients with moderate to severe COPD. METHODS: Seventy patients (aged ≥40 years, Global initiative for chronic Obstructive Lung Disease Stage II/III) were randomised (1:1:1:1:1:1) to single doses of abediterol 0.625, 2.5, 5 or 10 μg, indacaterol 150 μg or placebo. Spirometry was performed up to 36 h post-dose. Pharmacokinetics were assessed in a subset of patients (N = 20). Safety and tolerability were evaluated throughout the study. RESULTS: Abediterol (all doses) significantly improved change from baseline in trough forced expiratory volume in 1 s (FEV1) compared with placebo (0.102, 0.203, 0.233 and 0.259 L for abediterol 0.625, 2.5, 5 and 10 μg, respectively; all p < 0.0001; primary endpoint). Abediterol 2.5, 5 and 10 μg significantly improved trough FEV1 compared with indacaterol 150 μg (0.092, 0.122 and 0.148 L, respectively; all p < 0.0001). Improvements in bronchodilation were maintained at all time points post-dose versus placebo (all abediterol doses) and from 15 or 30 min post-dose versus indacaterol 150 μg with abediterol 2.5, 5 and 10 μg (all p < 0.05). Abediterol had low systemic exposure; incidence of treatment-emergent adverse events was similar between treatment groups. CONCLUSIONS: All doses of abediterol (0.625-10 μg) provided clinically and statistically significant, dose-dependent improvements in bronchodilation versus placebo, and abediterol 2.5, 5 and 10 μg gave significant improvements versus indacaterol. All doses of abediterol were safe and well tolerated in patients with COPD. TRIAL REGISTRATION: Clinicaltrials.gov NCT01425814 . Registered 29 August 2011.
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