Triple Therapy with Budesonide/Glycopyrronium/Formoterol Fumarate Dihydrate versus Dual Therapies for Patients with COPD and Phenotypic Features of Asthma: A Pooled Post Hoc Analysis of KRONOS and ETHOS.

Background: We evaluated the inhaled corticosteroid/long-acting muscarinic antagonist/long-acting β-agonist (ICS/LAMA/LABA) triple therapy with budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) versus dual LAMA/LABA and ICS/LABA therapies in patients with chronic obstructive pulmonary disease (COPD) and phenotypic features of asthma (bronchodilator reversibility and elevated blood eosinophils), but no asthma diagnosis, for whom treatment guidelines are limited.

Patients And Methods: KRONOS (NCT02497001) and ETHOS (NCT02465567) enrolled patients with moderate-to-very-severe COPD, no current asthma diagnosis, and either ≥0 (KRONOS) or ≥1 (ETHOS) moderate/severe exacerbations in the prior year. This pooled post hoc analysis evaluated trough forced expiratory volume in 1 second (FEV) and FEV area under the curve from hours 0 to 4 (AUC) change from baseline over 12-24 weeks, moderate/severe exacerbation rates, and St George's Respiratory Questionnaire (SGRQ) total score over 24 weeks with ICS/LAMA/LABA (BGF 320/14.

Comparability of critical quality attributes for establishing biosimilarity.

To develop a biosimilar product, it is essential to demonstrate the biosimilarity between the proposed biosimilar product and the reference product first in terms of quality in a stepwise approach that can then help inform the extent of safety and efficacy data that will be required to establish biosimilarity. These comparability studies should have direct side-by-side comparisons of the test and the reference products. In this paper, we develop a statistical method for unpaired head-to-head quality attribute comparisons.

Effectiveness of ciclesonide nasal spray in the treatment of seasonal allergic rhinitis.

Background: Ciclesonide is an investigational corticosteroid under development for treatment of allergic rhinitis. Ciclesonide is converted to active metabolite, desisobutyryl-ciclesonide (des-CIC), by upper and lower airway esterases. In vitro studies in human nasal epithelial cells and bronchial epithelial cells have demonstrated a long duration of anti-inflammatory activity of des-CIC.

Efficacy and safety of ciclesonide nasal spray for the treatment of seasonal allergic rhinitis.

Background: Allergic rhinitis (AR), an inflammatory disease of the nasal mucosa, affects approximately 25% of adults and 40% of children in the United States. Ciclesonide nasal spray is a corticosteroid being developed as a hypotonic formulation for AR.

Objective: We sought to evaluate the efficacy, safety, and tolerability of ciclesonide nasal spray in adult and adolescent patients with seasonal AR (SAR).

Evaluating assumptions for least squares analysis using the general linear model: a guide for the pharmaceutical industry statistician.

A review of graphical and test based methods for evaluating assumptions underlying the use of least squares analysis with the general linear model is presented along with some discussion of robustness. Alternative analyses are described for situations where there is evidence that the assumptions are not reasonable. Evaluation of the assumptions is illustrated through the use of an example from a clinical trial used for US registration purposes.