Results from a safety and efficacy trial of revefenacin (REV) demonstrated that the drug had a safety profile similar to foremoterol (FOR). In addition, patients with COPD in the suboptimal peak inspiratory flow rate trial (sPIFR) showed lower weight, BMI, and lung function in comparison to patients with optimal peak inspiratory flow rate (oPIFR), in a second study.1,2

Data from both studies were presented during the CHEST Annual Meeting in New Orleans, October 19-23, 2019.

The safety trial of revefenacin analyzed the distribution of REV when given sequentially before, or combined with FOR, via standard jet nebulizer in patients with COPD. In the study, 122 patients with moderate to severe COPD were randomized to receive REV or placebo, followed by FOR in the morning and evening for 21 days via standard jet nebulizer.1

The study concluded that REV had a safety profile similar to FOR alone when given sequentially before, or combined with, FOR via standard jet nebulizer. Adverse reactions included dizziness, cough, and oropharyngeal pain at a minimal level. The researchers concluded that sequential or combined delivery of a long-acting muscarinic antagonist (LAMA) and long-acting beta agonist (LABA) via standard jet nebulizer could be a treatment option for patients with COPD.1

In the sPIFR study, 525 patients with COPD were analyzed; 52% with sPIFR and 48% with oPIFR. The trial was indicated to compare patients with sPIFR and oPIFR and their resistance of dry powder inhalers (DPIs).2

The study showed that patients with sPIFR had lower weight, BMI, and lung function. In addition, these patients had longer COPD duration, severe airflow obstruction, and more symptomatic disease than patients with oPIFR.2

Researchers suggest that these clinical characteristics may be used to identify patients at risk for sPIFR who may not be able to derive adequate benefit from DPIs. It may be beneficial to measure PIFR and airflow limitation before considering treatment options for COPD, according to the study.2


REFERENCES
  1. Siler TM, Moran EJ, Yun J, Barnes CN, Crater G. Tolerability and efficacy of revefenacin when administered with formoterol via nebulization. Poster presented at: 2019 CHEST Annual Meeting; October 22, 2019; New Orleans, LA. Accessed October 22, 2019.
  2. Ohar JA, Mahler DA, Barnes CN, Crater G. Predictors of suboptimal peak inspiratory flow rate in patients with chronic obstructive pulmonary disease: analyses from the revefenacin phase 3 program. Poster presented at: 2019 CHEST Annual Meeting; October 22, 2019; New Orleans, LA. Accessed October 22, 2019.