Novartis has announced positive results from the FLASH study examining the safety and efficacy of directly switching chronic obstructive pulmonary disease (COPD) patients from Seretide (salmeterol/fluticasone) 50/500 mcg to Ultibro Breezhaler (indacaterol/glycopyrronium) 110/50 mcg. The study met the primary endpoint demonstrating that switching patients to Ultibro Breezhaler resulted in significantly improved lung function (trough FEV1).

The superiority of once-daily Ultibro Breezhaler over twice-daily salmeterol/fluticasone in improving lung function and reducing the rate of COPD exacerbations has been established in previous studies. The FLASH study is the first randomized controlled trial to confirm the benefits of directly switching patients from this steroid-containing therapy to the dual bronchodilator, therefore avoiding the side effects of the long-term use of inhaled corticosteroids. Importantly, patients were switched without a wash-out period to mimic clinical practice.

"It has already been established that Ultibro Breezhaler improves patients' lung function when directly compared to Seretide in clinical trials," said Shreeram Aradhye, chief medical officer and global head of Medical Affairs for Novartis Pharmaceuticals. "This new research is important because it shows that this benefit also exists when directly switching patients from Seretide to Ultibro Breezhaler as would happen in everyday clinical practice. The FLASH study provides further evidence that it is possible to reduce the burden of long-term inhaled steroids in many COPD patients, as recommended by global treatment guidelines".
 
These results further reinforce the latest GOLD recommendations, which support the use of dual bronchodilation for the majority of symptomatic COPD patients and limit the use of steroid-containing therapies to specific patient types.  

Importantly, the data released today also indicated that the safety and tolerability profiles of the two treatments were similar.  

The FLASH study results were presented at the Asian Pacific Society of Respirology (APSR) Congress in Sydney, Australia (23-26 November 2017).

The FLASH study is a randomized, multicenter, double-blind, double-dummy, parallel-group, 12-week treatment trial. It involved a total of 502 moderate-to-severe symptomatic and non-frequently exacerbating chronic obstructive pulmonary disease (COPD) patients.

The primary objective of the study was to demonstrate the superiority of once-daily Ultibro Breezhaler 110/50 mcg compared with twice-daily salmeterol/fluticasone (50/500 mcg) in terms of improving lung function (trough pre-dose FEV1 at Week 12).  

Secondary objectives of the study were to investigate the effect of Ultibro Breezhaler compared with salmeterol/fluticasone on:  Transition Dyspnea Index (TDI) focal score at Week 12. Trough pre-dose forced expiratory vital capacity (FVC) at Week 12. COPD symptoms at Week 12 as measured by the COPD Assessment Test (CAT)  Mean rescue medication use (puffs/day) and percentage of days without rescue medication use over 12 weeks

The study also assessed the safety and tolerability over 12 weeks (including adverse events, serious adverse events and COPD exacerbations).