Indacaterol/glycopyrronium (IND/GLY) is more effective than salmeterol/fluticasone (SFC) in reducing exacerbations, regardless of outcome measurement utilised: Results from the FLAME study

Introduction Current GOLD strategy recommends LABA/ICS and/or LAMA as first-choice for treatment of COPD patients at risk of exacerbation. The FLAME study compared dual bronchodilation effect of IND/GLY (LABA/LAMA) vs SFC (LABA/ICS) on exacerbations in patients with moderate-to-very severe COPD and ≥1 exacerbation in the previous year. Methods This 52-week, multicentre, double-blind study randomised patients (1:1; post-bronchodilator FEV 1 predicted ≥25– Results Out of 3362 patients randomised, 82.2% patients completed 52 weeks of treatment and a subset of 13.5% patients completed the EXACT-PRO. All measures of exacerbations demonstrated a lower rate of events in patients treated with IND/GLY compared with SFC (Table). Conclusions IND/GLY was more effective than SFC in reducing exacerbations. Results from EXACT-PRO were similar to e-diary, with statistical analysis reflecting smaller sample size.