Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma

Research

Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma: a randomised dose-ranging study

Richard M Follows, Neil G Snowise, Shu-Yen Ho, Claire L Ambery, Kevin Smart and Barbara A McQuade

For all author emails, please log on.

Respiratory Research 2013, 14:54 doi:10.1186/1465-9921-14-54

Published: 17 May 2013

Abstract (provisional)

Background

GSK2190915 is a high affinity 5-lipoxygenase-activating protein inhibitor being developed for the treatment of asthma. The objective of this study was to evaluate GSK2190915 efficacy, dose--response and safety in subjects with persistent asthma treated with short-acting beta2-agonists (SABAs) only.

Methods

Eight-week multicentre, randomised, double-blind, double-dummy, stratified (by age and smoking status), parallel-group, placebo-controlled study in subjects aged 12 years or more with a forced expiratory volume in 1 second (FEV1) of 50--85% predicted. Subjects (n = 700) were randomised to receive once-daily (QD) oral GSK2190915 (10--300 mg), twice-daily inhaled fluticasone propionate 100 mug, oral montelukast 10 mg QD or placebo. The primary endpoint was mean change from baseline (randomisation) in trough (morning pre-dose and pre-rescue bronchodilator) FEV1 at the end of the 8-week treatment period. Secondary endpoints included morning and evening peak expiratory flow, symptom-free days and nights, rescue-free days and nights, day and night-time symptom scores, day and night-time rescue medication use, withdrawals due to lack of efficacy, Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores.

Results

For the primary endpoint, there was no statistically significant difference between any dose of GSK2190915 QD and placebo. However, repeated measures sensitivity analysis demonstrated nominal statistical significance for GSK2190915 30 mg QD compared with placebo (mean difference: 0.115 L [95% confidence interval: 0.00, 0.23], p = 0.044); no nominally statistically significant differences were observed with any of the other doses. For the secondary endpoints, decreases were observed in day-time symptom scores and day-time SABA use for GSK2190915 30 mg QD versus placebo. No dose--response relationship was observed for the primary and secondary endpoints across the GSK2190915 dose range studied; the 10 mg dose appeared to be sub-optimal. GSK2190915 was associated with a dose-dependent reduction in urinary leukotriene E4. The profile and incidence of adverse events were similar between treatment groups.

Conclusion

Efficacy was demonstrated for GSK2190915 30 mg compared with placebo in day-time symptom scores and day-time SABA use. No additional improvement on efficacy endpoints was gained by administration of GSK2190915 doses greater than 30 mg. GSK2190915 was well-tolerated. These results may support further studies with GSK2190915 30 mg.

Trial registration: Clinicaltrials.gov: NCT01147744.http://www.clinicaltrials.gov/ct2/show/NCT01147744?term=NCT01147744&rank=1

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.