Key result
Once-daily umeclidinium/vilanterol significantly improved trough FEV1 by a mean difference of 163 mL compared with placebo at day 84 in symptomatic COPD patients aged 65 years and older.
Why the study?
Does umeclidinium/vilanterol improve lung function in elderly symptomatic patients with COPD?
Meta-Analysis (n=3,751)
Double-blind
Randomized
Yes
Does umeclidinium/vilanterol improve lung function in elderly symptomatic patients with COPD?
Mean Difference: 163 (95% CI 128–199)
Absolute Event Rate: 183% vs 20%
p-value: p=<0.001
Once-daily umeclidinium/vilanterol provides clinically significant lung function benefits compared with placebo in both younger and older patients with COPD, with a similar safety profile.
Supports UMEC/VI in elderly symptomatic COPD; extends RCT evidence of consistent lung function gains and safety across ages.
The aim of this pooled analysis was to assess the efficacy and safety of umeclidinium/vilanterol (UMEC/VI) 62.5/25 µg dual bronchodilation versus placebo in elderly symptomatic patients with chronic obstructive pulmonary disease (COPD). We conducted a post hoc pooled analysis of data from 10 randomized controlled trials (RCTs). Change from baseline (CFB) in trough forced expiratory volume in 1 s (FEV 1 ), proportion of FEV 1 responders (≥ 100-mL increase from baseline), and safety were analyzed in patients aged < 65, ≥ 65, and ≥ 75 years on Days 28, 56, and 84 (12-week analysis of parallel-group design studies), Days 28, 56, 84, 112, 140, 168, and 169 (24-week analysis of parallel-group design studies), and Days 2, 42, and 84 (12-week analysis of crossover design studies). The UMEC/VI intent-to-treat (ITT) populations comprised 2246, 1296, and 472 patients in the 12-week parallel-group, 24-week parallel-group, and 12-week crossover analysis, respectively (≥ 65 years: 36–44%; ≥ 75 years: 7–11%). The placebo ITT populations comprised 528, 280, and 505 patients, respectively (≥ 65 years: 37–41%; ≥ 75 years: 5–11%). Significant improvements in trough FEV 1 and significantly greater proportions of FEV 1 responders were seen with UMEC/VI compared with placebo in all analyses regardless of patient age or timepoint considered ( p ≤ 0.023), except Day 84 trough FEV 1 CFB in the 12-week crossover analysis in patients aged ≥ 75 years ( p = 0.064). UMEC/VI safety profile was similar to placebo in all age groups. In this pooled analysis of RCT data, once-daily UMEC/VI was well tolerated and provided clinically significant lung function benefits compared with placebo in younger and older patients with COPD. GlaxoSmithKline (study 208125).
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Ray et al. (2018) conducted a meta-analysis in Symptomatic chronic obstructive pulmonary disease (COPD) (n=3,751). Umeclidinium/vilanterol vs. Placebo was evaluated on Change from baseline in trough FEV1 at Day 84 in patients ≥65 years (12-week parallel-group analysis) (MD 163 mL, 95% CI 128-199, p=<0.001). Once-daily umeclidinium/vilanterol significantly improved trough FEV1 by a mean difference of 163 mL compared with placebo at day 84 in symptomatic COPD patients aged 65 years and older.
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