Eosinophil levels do not influence outcomes with triple combo asthma inhaler

Treatment with fixed-dose asthma inhaler combination of mometasone/indacaterol/glycopyrronium (MF/IND/GLY) helps improve lung function and reduce exacerbations as compared with MF/IND and fluticasone/salmeterol (FLU/SAL), regardless of baseline eosinophil levels, according to a post hoc analysis of the IRIDIUM study.

The analysis included 3,065 patients who received one of the following treatments: high-dose MF/IND/GLY (160/150/50 μg, once a day), high-dose MF/IND (320/150 μg, once a day), and high-dose FLU/SAL (500/50 μg, twice a dy). Researchers evaluated the efficacy of the treatments in patient subgroups with baseline blood eosinophil count of <300 cells/μL or ≥300 cells/μL.

At week 26, patients who received high-dose MF/IND/GLY showed improved trough FEV1 compared with those treated with high-dose MF/IND (difference, 78 mL [<300 cells/μL] and 54 mL [≥300 cells/μL]) and FLU/SAL (difference, 112 mL [<300 cells/μL] and 98mL [≥300 cells/μL]). Similarly, pooled MF/IND/GLY (160/150/50 μg and 80/150/50 μg) also resulted in significantly improved trough FEV1 vs pooled MF/IND (320/150 μg and 160/150 μg; difference, 75 mL [<300 cells/μL] and 68 mL [≥300 cells/μL]).

Over 52 weeks, high-dose MF/IND/GLY decreased the annualized rate of moderate or severe asthma exacerbations by 23 percent and 10 percent, severe exacerbations by 31 percent and 15 percent, and all exacerbations by 33 percent and 10 percent compared with high-dose MF/IND for subgroups with <300 cells/uL and ≥300 cells/uL, respectively. The corresponding improvements in exacerbations relative to FLU/SAL were 33 percent and 41 percent, 45 percent and 42 percent, 42 percent and 39 percent.

Likewise, pooled MF/IND/GLY reduced exacerbations by 22 percent and 8 percent, 21 percent and 7 percent, 27 percent and 8 percent compared with pooled MF/IND for the respective subgroups.