Obstructive Lung Diseases: Airways 2 |

POWER: Prospective Cohort Study for the Real-Life Effectiveness Evaluation of Glycopyrronium With Indacaterol Combination in the Management of COPD in Canada FREE TO VIEW

Alan Kaplan, MD; Michel Djandji, MD; Jasmin Belle-Isle, MD; Syed Anees, MD; Andrew McIvor, MD; John Sampalis, PhD; Irvin Mayers, MD
Author and Funding Information

JSS Medical Research, St-Laurent, QC, Canada

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):835A. doi:10.1016/j.chest.2016.08.935
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Randomized clinical trials have shown that QVA149, the combination of indacaterol 110 mcg and glycopyrronium 50 mcg, is effective in the management of patients with moderate to severe COPD. To date, there are no real-life Canadian studies evaluating its effectiveness in the management of symptomatic patients as monotherapy replacing tiotropium or fixed dose LABA/ICS. The POWER study addresses this need.

METHODS: POWER is a single cohort, Canadian, prospective post approval study that will enroll approximately 710 patients with moderate to severe COPD who may have had ≤ 1 exacerbation in the previous year and treated by community and hospital based general practitioners and specialists. Patients that remain symptomatic on their current treatment of tiotropium alone or with a fixed-dose combination (FDC) of fluticasone propionate/salmeterol alone are treated with QVA149 for 16 weeks. All treatments were as per the judgment of the physician. Effectiveness outcome measures are change in FEV1 and COPD Assessment Questionnaire (CAT) at 16 weeks. We are reporting the results of the first 116 patients reaching 16 weeks of follow up.

RESULTS: Of the 116 patients 37 and 79 were switched from fluticasone propionate/salmeterol (FS->QVA) or tiotropium (TIO->QVA) respectively. The mean (SD) age of the study cohort was 66.3 (8.68) years and 53.4% were male. At 16 weeks of treatment, the 2 groups experienced clinically and statistically significant improvements in FEV1 and CAT. Specifically, FEV1 significantly increased by a mean (SD) of 129 (253) ml (p<0.001) in the total population; 156 (315) ml (p=0.006) and 116 (221) ml (p<0.001) among previous FS and TIO users, respectively. Furthermore, overall, CAT values significantly reduced by a mean (SD) of 6.9 (7.5) points (p<0.001); 8.4 (8.5) (p<0.001) and 6.1 (7.0) points (p<0.001) among the same respective populations. However, these improvements were similar between the groups.

CONCLUSIONS: The results of the POWER study show that QVA149 (LABA/LAMA combination) is effective in improving respiratory and functional outcomes in patients with COPD that have failed previous treatment with FDC (FS) or TIO.

CLINICAL IMPLICATIONS: Bronchodilators are the cornerstone of symptomatic management of chronic obstructive pulmonary disease (COPD). Current guidelines recommend treatment with one or more long-acting bronchodilators for patients with moderate-to-very severe COPD. Despite these recommendations, there is evidence of widespread and possibly inappropriate use of ICS in patients with COPD and some patients are treated with a LABA/ICS combination as a 1st line treatment. The current POWER study, confirms that in a real world setting when patients with COPD, at low risk of exacerbations and who remain symptomatic although receiving a mono-bronchodilator or inappropriately a LABA/ICS FDC can benefit from a switch to Indacterol/Glycoyrronium combination. This switch will improve, significantly, their lung functions as well as their QoL and may reduce the inappropriate use of ICS in a large proportion of COPD patients.

DISCLOSURE: Alan Kaplan: Grant monies (from industry related sources): AstraZeneca, Boehringer Ingelheim, Novartis, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Boehringer Ingelheim, Griffols, Merck Frosst, Pfizer, Purdue, Novartis, Sanofi, Takeda, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Boehringer Ingelheim, Aerocrine, GSK, Pfizer, Purdue, Meda, Novartis Michel Djandji: Employee: Novartis Canada Jasmin Belle-Isle: Consultant fee, speaker bureau, advisory committee, etc.: Novartis Syed Anees: Consultant fee, speaker bureau, advisory committee, etc.: Novartis, Boehringer Ingelheim, Roche Andrew McIvor: Consultant fee, speaker bureau, advisory committee, etc.: Novartis John Sampalis: Employee: JSS Medical Research Inc. Irvin Mayers: Grant monies (from industry related sources): Genentech, Alberta Innovates Health Solutions, Grant monies (from sources other than industry): Public Health Agency, Consultant fee, speaker bureau, advisory committee, etc.: Grifols, Boehringer Ingelheim, Novartis, Takeda, Almirall, Astra Zeneka

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