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瑞福纳嗪对中重度至极重度 COPD 患者的曲线下面积肺活量测定影响。

Revefenacin Area Under the Curve Spirometry in Patients with Moderate to Very Severe COPD.

机构信息

Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

Theravance Biopharma US, Inc, South San Francisco, CA, USA.

出版信息

Int J Chron Obstruct Pulmon Dis. 2024 Oct 16;19:2299-2308. doi: 10.2147/COPD.S483176. eCollection 2024.

Abstract

PURPOSE

Several lung function endpoints are utilized in clinical trials of inhaled bronchodilators for chronic obstructive pulmonary disease (COPD). Trough forced expiratory volume in 1 second (FEV) is a commonly reported endpoint in COPD trials and can be complemented by area under the FEV vs time curve (FEV AUC), which provides information on duration and consistency of bronchodilation over a dosing interval. Revefenacin, a once-daily bronchodilator, significantly improved lung function in patients with COPD when measured by trough FEV in two replicate Phase 3 trials. Here, we report an FEV AUC substudy using data from these trials.

PATIENTS AND METHODS

This post hoc analysis examined substudy data from 12-week replicate Phase 3 trials (NCT02459080/NCT02512510); patients with moderate to very severe COPD were randomized 1:1 to revefenacin 175 μg or placebo once daily. The substudy patients had FEV AUC assessed on Day 1, and those who continued to Day 84 also underwent 24-hour serial spirometry postdose where FEV AUC AUC, AUC, and AUC were evaluated.

RESULTS

Fifty and 47 patients who received revefenacin and placebo underwent 24-hour serial spirometry; most baseline characteristics were aligned between groups. At Day 84 postdose, revefenacin demonstrated sustained improvements in bronchodilation over 24 hours; differences in least squares mean vs placebo were 282, 220, 205, and 212 mL for FEV AUC, AUC, AUC, and AUC (all <0.001), respectively.

CONCLUSION

This substudy analysis supplements previous findings that revefenacin provides sustained bronchodilation over 24 hours. Assessing additional complementary COPD clinical trial endpoints can help clinicians make treatment decisions.

摘要

目的

在慢性阻塞性肺疾病(COPD)的吸入性支气管扩张剂临床试验中,使用了几种肺功能终点。1 秒用力呼气量(FEV)谷值是 COPD 试验中常用的报告终点,可通过 FEV 与时间曲线下面积(FEV AUC)来补充,该参数提供了在给药间隔内支气管扩张的持续时间和一致性的信息。在两项重复的 3 期临床试验中,每日一次的支气管扩张剂 revefenacin 可显著改善 COPD 患者的肺功能,FEV 谷值得到了测量。在此,我们报告了来自这些试验的 FEV AUC 亚研究结果。

患者和方法

这是一项事后分析,研究了为期 12 周的重复 3 期临床试验(NCT02459080/NCT02512510)的亚研究数据;中重度至重度 COPD 患者按 1:1 随机分为 revefenacin 175μg 或安慰剂每日一次。亚研究患者在第 1 天评估 FEV AUC,继续治疗至第 84 天的患者还接受了 24 小时连续肺活量测定,评估 FEV AUC、AUC、AUC 和 AUC。

结果

接受 revefenacin 和安慰剂的 50 名和 47 名患者进行了 24 小时连续肺活量测定;两组的大多数基线特征一致。在给药后第 84 天,revefenacin 显示出持续 24 小时的支气管扩张改善;与安慰剂相比,最小二乘均数的差异分别为 282、220、205 和 212mL,用于 FEV AUC、AUC、AUC 和 AUC(均 <0.001)。

结论

这项亚研究分析补充了之前的发现,即 revefenacin 可提供持续 24 小时的支气管扩张作用。评估其他补充 COPD 临床试验终点可以帮助临床医生做出治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbd/11491098/02c3d04e19ab/COPD-19-2299-g0001.jpg

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