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Nebulized Fluticasone Propionate VS Oral Prednisone in Chinese Pediatric and Adolescent Subjects With an Acute Exacerbation of Asthma

A Multicentre, Randomized, Double-blind, Double-dummy, Active-controlled, Parallel-group Study to Determine the Efficacy and Safety of Nebulized Fluticasone Propionate 1mg Twice Daily Compared With Oral Prednisone Administered for 7 Days to Chinese Pediatric and Adolescent Subjects (Aged 4 to 16 Years) With an Acute Exacerbation of Asthma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01687296
Enrollment
261
Registered
2012-09-18
Start date
2012-11-12
Completion date
2013-06-21
Last updated
2018-06-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Asthma

Keywords

PEF, inhaled, Fluticasone Propionate, safety, prednisone, acute exacerbation, asthma, efficacy

Brief summary

This is a multicentre, randomized, double-blind, double-dummy, active-controlled, parallel-group study to determine the efficacy and safety of nebulized fluticasone propionate 1mg twice daily compared with oral prednisone administered for 7 days to Chinese pediatric and adolescent subjects (aged 4 to 16 years) with an acute exacerbation of asthma

Detailed description

This is a multicentre, randomized, double-blind, double-dummy, active-controlled, parallel-group study to determine the efficacy and safety of nebulized fluticasone propionate (FP) 1mg twice daily compared with oral prednisone administered for 7 days to Chinese pediatric and adolescent subjects (aged 4 to 16 years) with an acute exacerbation of asthma. This study is for supporting registration of FP Nebules treating Chinese pediatric and adolescent subjects (aged 4 to 16 years) with an acute exacerbation of asthma in China. At least 250 subjects, aged 4-16 years old, diagnosed an acute exacerbation of asthma at presentation, are eligible to take part in the study if they meet the inclusion criteria. They are randomly assigned at the ratio 1:1 to one of the following treatment groups for 7 days: FP Nebules 2×0.5mg/2ml twice daily/Placebo tablets once daily; Or, Oral prednisone tablets once daily (2mg/kg.day, up to 40mg/day for 4 days, then 1mg/kg.day or half of the original dose, up to 20mg/day for 3 days) / Placebo Nebules 2×2ml 0.9% saline twice daily. While all subjects are given Salbutamol Nebules / MDI for relief of symptoms. After randomization (visit 1), the following visits are on Day5 (visit 2) and Day8 (visit 3), and a follow-up phone call (visit4) will happen two weeks post treatment on Day 21 for collection of adverse events. The primary endpoint is mean morning PEF on diary card over the treatment assessment period. The secondary endpoints include subject derived data (symptom scores ), evening PEF on diary card, use of rescue medications, clinic assessments of pulmonary function ( FEV1, and FVC) , clinical scoring index , patient/parent and investigator global evaluation, and use of rescue medications during the trial. Safety endpoints include AEs, vital signs, and oropharyngeal examinations, and laboratory tests (haematology, urinalysis, chemistry). The subjects are assessed for compliance on completion of diary card.

Interventions

2×0.5mg/2ml twice daily nebulized to treat an acute exacerbation of asthma for 7 days

once daily (2mg/kg.day, up to 40mg/day for 4 days, then 1mg/kg.day or half of the original dose, up to 20mg/day for 3 days) to treat an acute exacerbation of asthma for 7 days

4ml 0.9% saline nebulized twice daily

DRUGplacebo tablet

placebo soluble tablet, oral ,once daily

DRUGsalbutamol

Salbutamol MDI 2 puffs twice daily or Nebules twice daily, and can be increased up to every 4 hours on an as-needed basis, through the treatment period.

Sponsors

GlaxoSmithKline
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Eligibility

Sex/Gender
ALL
Age
4 Years to 16 Years
Healthy volunteers
No

Inclusion criteria

* Chinese male and female pediatric or adolescent subjects aged 4 to 16 years, inclusive * Subjects have an established diagnosis of asthma * The definition of asthma. According to Chinese Guideline for the diagnosis and optimal management of asthma in children \[Respiratory branch of pediatric society,Chinese Medical. Association. 2008, revised version\], the subjects can be diagnosed when meeting the criteria. The diagnosis criteria is listed in the protocol. * The severity of an acute exacerbation of asthma is defined as PEF of 50% to 75% predicted via a peak flow meter, with a clinical scoring index of ≥2. The clinical scoring index represents the sum of the score for each of four signs: respiratory rate (0=low to 3=high, dependent on age), wheezing (0=none to 3=severe), inspiration/expiration ratio (0=2:1 to 3=1:3), and accessory muscle (0=none to 3=marked use). * Subjects can properly use a mini-wright peak flow meter, nebulizer and MDI with/without a spacer, and accurately complete a diary card with parental assistance, if required. * Subjects' parents/guardians are willing to give written informed consent.

Exclusion criteria

* Severe respiratory dysfunction. * History of mechanical ventilation due to respiratory failure. * Admission to hospital due to respiratory disease within the previous 2 weeks, including asthmatic exacerbations. * Clinical or lab evidence of a serious, uncontrolled systemic disease or presence of any disease likely to interfere with the objectives of this study, such as pulmonary cystic fibrosis and bronchopulmonary dysplasia. * Known or suspected hypersensitivity to glucocorticosteroids or β2 agonists. * Clinical visual evidence of oral candidiasis at Visit1. * Use of the medications below in Table 1 according to the following defined time intervals prior to presentation. The list is provided in the protocol.

Design outcomes

Primary

MeasureTime frameDescription
Mean Morning Peak Expiratory Flow (AM PEF) on Diary Card Over the Treatment Assessment Period in Intent-to-Treat (ITT) PopulationDays 2 to 8PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before taking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 4 participants from prednisone group had the missing outcome measure. Analysis was performed using an analysis of covariance (ANCOVA) model with effects due to gender, age, centre and treatment group.
Mean Morning PEF on Diary Card Over the Treatment Assessment Period in Per Protocol (PP) PopulationDays 2 to 8PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before talking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 5 participants from prednisone group had the missing outcome measure. Analysis was performed using ANCOVA model with effects due to gender, age ,centre and treatment group.

Secondary

MeasureTime frameDescription
Median Number of Use of Rescue Medications During Day and Night Over the Treatment Assessment PeriodDays 2 to 8The use of nebulized salbutamol (doses/puffs and frequency) were recorded on diary card in the morning and evening. The median numbers of times of use of rescue medication during day and night was calculated for each participant over the treatment assessment period. In each case, only data that was from Days 2 to 8 after randomization and before or on the end date of study drug was used. The outcome measure was considered missing if less than 2 days (that is., 24-hour periods) were recorded in the given treatment assessment period. The analysis only includes participants who have at least 2 days of non-missing numbers of times rescue medication (including zero) in the given treatment assessment period.
Clinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodDuring the treatment period at Day 5, Day 8Spirometric assessments of FEV1 and FVC were assessed at clinic visit 1 (Screening), 2 (Day 5) and 3 (Day 8). Lung function tests were performed at the approximately same time at each visit in the morning. Participants were instructed to withhold salbutamol therapy for at least 4 hour, and the highest of three FEV1 and FVC measurements were recorded. If participants discontinued before or on Day 5, then the FEV1 and FVC collected at the early withdrawal visit is included in the Visit 2. Otherwise, the FEV1, FVC collected at the early withdrawal visit was included in the Visit 3. Analysis was performed using ANCOVA with covariates of gender, centre, age and treatment.
Mean Evening PEF on Diary Card Over the Treatment Assessment PeriodDays 1/2 to 8PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the evening (6:00-9:00 post meridiem \[PM\]) before taking any study drug. Only data that was drawn from Days 1/2 to 8 after randomization and before or on the end date of study drug was used for analysis. If participants started to take the study drug in the morning (early or on 12:00 PM), only then the evening PEF on the date of randomization was used. The outcome measure was considered missing if less than 2 days was recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 5 participants from prednisone group had the missing outcome measure. Analysis was performed using an ANCOVA model with effects due to gender, age, centre and treatment group.
Mean Global Evaluation for Efficacy by Participant/Parent and InvestigatorDay 8At Visit 3 (Day 8), participant/parent and investigator were asked to evaluate efficacy globally as very beneficial=1, beneficial=2, no effect=3 or worse=4. The global evaluation collected at the early withdrawal visit was included in the Visit 3. If participants were discontinued at Visit 2, then the global evaluation collected at the Visit 2 is also included in the Visit 3 for summary and analysis.
Mean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8Baseline, Day 5 and Day 8The clinical scoring index was assessed at Baseline (Visit 1), Day 5 and Day 8. The score assigned represented the sum of the score for each of four signs: respiratory rate, wheezing, inspiration/expiration ratio, and accessory muscle use. Each of these parameters were scored on a 4-point scale of 0 to 3 where 0=none, 1=mild, 2=moderate and 3=severe. The total score ranged from 0 to 12, where 0 indicated absence of symptoms and 12 indicated most severe symptoms. The Baseline value was the last non-missing value prior to randomization. Change from Baseline was calculated/defined as value at the indicated visit minus value at the Baseline. A negative value of change in score from Baseline indicated improvement in severity of symptoms. If participants discontinued before or on Day 5, then the clinical scoring index collected at the early withdrawal visit was included in the Visit 2. Otherwise, the clinical scoring index collected at the early withdrawal visit was included in the Visit 3
Median Day-time and Night-time Symptom Scores Over the Treatment Assessment PeriodDays 2 to 8The symptoms of cough, sputum production, wheeze and dyspnoea were assessed in morning and evening, and recorded on participant diary cards. Day-time symptoms were scored while retiring to bed on a scale of 0 (no symptoms) to 5 (severe). Night-time symptoms were scored while waking in the morning on a scale of 0 (no symptoms) to 4 (severe). For day-time score, only data that was from Days 2 to 8 after randomization and before or on the end date of study drug was used. For night-time score, only data that are from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. The analysis only includes participants with at least 2 days of non-missing symptom scores in the given treatment assessment period.

Countries

China

Participant flow

Recruitment details

The study was planned on 250 Chinese paediatric and adolescent participants (aged 4 to 16 years) with an acute exacerbation of asthma and was conducted at 11 centres in China from 12th November 2012 to 21st June 2013.

Pre-assignment details

A total of 266 participants (par) were screened for this study. Of these, 5 participants were screen failures. A total of 261 participants were randomized to receive either nebulized fluticasone or oral prednisone. A total of 251 participants received at least a single dose study drug.

Participants by arm

ArmCount
Fluticasone Propionate
Participants received fluticasone propionate inhalation solution BID 2x0.5 mg/mL via a nebulizer in morning and evening for 7 days. Blinding was maintained by administration of placebo soluble tablets once daily in the morning for 7 days. Salbutamol was provided on a needed basis throughout the treatment period.
123
Prednisone
Participants received oral prednisone tablets once daily at 2 mg per kg per day, up to 40 mg per day for 4 days, then 1 mg per kg per day or half of the original dose, up to 20 mg per day for 3 days in the morning. Blinding was maintained by administration of placebo nebules 2×2mL 0.9% saline BID in morning and evening for 7 days. Salbutamol was provided on a needed basis throughout the treatment period.
128
Total251

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLack of Efficacy11
Overall StudyProtocol Violation01
Overall StudyWithdrawal by Subject63

Baseline characteristics

CharacteristicFluticasone PropionatePrednisoneTotal
Age, Continuous6.6 Years
STANDARD_DEVIATION 2.41
6.5 Years
STANDARD_DEVIATION 2.32
6.5 Years
STANDARD_DEVIATION 2.36
Region of Enrollment
China
123 Participants128 Participants251 Participants
Sex: Female, Male
Female
51 Participants51 Participants102 Participants
Sex: Female, Male
Male
72 Participants77 Participants149 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 1230 / 128
other
Total, other adverse events
1 / 12310 / 128
serious
Total, serious adverse events
1 / 1232 / 128

Outcome results

Primary

Mean Morning Peak Expiratory Flow (AM PEF) on Diary Card Over the Treatment Assessment Period in Intent-to-Treat (ITT) Population

PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before taking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 4 participants from prednisone group had the missing outcome measure. Analysis was performed using an analysis of covariance (ANCOVA) model with effects due to gender, age, centre and treatment group.

Time frame: Days 2 to 8

Population: ITT Population comprised of all participants randomized to treatment and who received at least one dose of study drug. Data is presented for the participants available at the time of assessment.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Fluticasone PropionateMean Morning Peak Expiratory Flow (AM PEF) on Diary Card Over the Treatment Assessment Period in Intent-to-Treat (ITT) Population188.77 Litres per minute (L/min)Standard Error 3.774
PrednisoneMean Morning Peak Expiratory Flow (AM PEF) on Diary Card Over the Treatment Assessment Period in Intent-to-Treat (ITT) Population188.31 Litres per minute (L/min)Standard Error 3.79
Comparison: 250 par were to be enrolled to achieve 200 total evaluable par or 100 evaluable par per group. Sample size was based on the primary efficacy endpoint (AM PEF) and had 80% power to reject the null hypothesis: nebulized FP (1 mg BID) was inferior to oral prednisone with regard to AM PEF using one-side t test at significance level 2.5%, and assuming true treatment difference (FP minus predisone) was 3.6 L/min, noninferiority margin was -12L/min, and common standard deviation was 39 L/min.p-value: 0.93195% CI: [-9.85, 10.76]ANCOVA
Primary

Mean Morning PEF on Diary Card Over the Treatment Assessment Period in Per Protocol (PP) Population

PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants (if needed with the help of parents or guardian) recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the morning before talking any study drug. Only data that was drawn from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used for analysis. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 5 participants from prednisone group had the missing outcome measure. Analysis was performed using ANCOVA model with effects due to gender, age ,centre and treatment group.

Time frame: Days 2 to 8

Population: PP Population comprised of all participants in the ITT Population who did not have any full protocol violations which could impact treatment effect. Data is presented for the participants available at the time of assessment.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Fluticasone PropionateMean Morning PEF on Diary Card Over the Treatment Assessment Period in Per Protocol (PP) Population189.46 L/minStandard Error 3.724
PrednisoneMean Morning PEF on Diary Card Over the Treatment Assessment Period in Per Protocol (PP) Population188.96 L/minStandard Error 3.712
p-value: 0.92295% CI: [-9.64, 10.65]ANCOVA
Secondary

Clinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment Period

Spirometric assessments of FEV1 and FVC were assessed at clinic visit 1 (Screening), 2 (Day 5) and 3 (Day 8). Lung function tests were performed at the approximately same time at each visit in the morning. Participants were instructed to withhold salbutamol therapy for at least 4 hour, and the highest of three FEV1 and FVC measurements were recorded. If participants discontinued before or on Day 5, then the FEV1 and FVC collected at the early withdrawal visit is included in the Visit 2. Otherwise, the FEV1, FVC collected at the early withdrawal visit was included in the Visit 3. Analysis was performed using ANCOVA with covariates of gender, centre, age and treatment.

Time frame: During the treatment period at Day 5, Day 8

Population: ITT Population. Only those participants available at the specified time points were analyzed.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Fluticasone PropionateClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFEV1, Day 51.288 LitresStandard Error 0.0348
Fluticasone PropionateClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFEV1, Day 81.400 LitresStandard Error 0.0294
Fluticasone PropionateClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFVC, Day 51.476 LitresStandard Error 0.0454
Fluticasone PropionateClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFVC, Day 81.544 LitresStandard Error 0.0326
PrednisoneClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFVC, Day 81.582 LitresStandard Error 0.0316
PrednisoneClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFEV1, Day 51.331 LitresStandard Error 0.0332
PrednisoneClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFVC, Day 51.543 LitresStandard Error 0.0439
PrednisoneClinical Assessment of Lung Function of Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) During the Treatment PeriodFEV1, Day 81.396 LitresStandard Error 0.028
Comparison: Fluticasone propionate versus Prednisone for FEV1 on Day 5p-value: 0.34895% CI: [-0.135, 0.048]ANCOVA
Comparison: Fluticasone propionate versus Prednisone for FEV1 on Day 8p-value: 0.91495% CI: [-0.074, 0.083]ANCOVA
Comparison: Fluticasone propionate versus Prednisone for FVC on Day 5p-value: 0.27695% CI: [-0.187, 0.054]ANCOVA
Comparison: Fluticasone propionate versus Prednisone for FVC on Day 8p-value: 0.38495% CI: [-0.126, 0.049]ANCOVA
Secondary

Mean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8

The clinical scoring index was assessed at Baseline (Visit 1), Day 5 and Day 8. The score assigned represented the sum of the score for each of four signs: respiratory rate, wheezing, inspiration/expiration ratio, and accessory muscle use. Each of these parameters were scored on a 4-point scale of 0 to 3 where 0=none, 1=mild, 2=moderate and 3=severe. The total score ranged from 0 to 12, where 0 indicated absence of symptoms and 12 indicated most severe symptoms. The Baseline value was the last non-missing value prior to randomization. Change from Baseline was calculated/defined as value at the indicated visit minus value at the Baseline. A negative value of change in score from Baseline indicated improvement in severity of symptoms. If participants discontinued before or on Day 5, then the clinical scoring index collected at the early withdrawal visit was included in the Visit 2. Otherwise, the clinical scoring index collected at the early withdrawal visit was included in the Visit 3

Time frame: Baseline, Day 5 and Day 8

Population: ITT Population. Only those participants available at the specified time points were analyzed.

ArmMeasureGroupValue (MEAN)Dispersion
Fluticasone PropionateMean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8Day 5-2.7 Scores on a scaleStandard Deviation 1.41
Fluticasone PropionateMean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8Day 8-3.4 Scores on a scaleStandard Deviation 1.26
PrednisoneMean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8Day 5-2.6 Scores on a scaleStandard Deviation 1.44
PrednisoneMean Change From Baseline in Clinical Scoring Index at Day 5 and Day 8Day 8-3.4 Scores on a scaleStandard Deviation 1.26
Comparison: Fluticasone propionate versus Prednisone for clinical scoring index on Day 5p-value: 0.507Wilcoxon rank sum test
Comparison: Fluticasone propionate versus Prednisone for clinical scoring index on Day 8p-value: 0.7Wilcoxon rank sum test
Secondary

Mean Evening PEF on Diary Card Over the Treatment Assessment Period

PEF is the maximum flow generated during a forceful exhalation, starting from full lung inflation. Participants recorded on diary card the best of three PEF measurements, using a mini-Wright peak flow meter in the evening (6:00-9:00 post meridiem \[PM\]) before taking any study drug. Only data that was drawn from Days 1/2 to 8 after randomization and before or on the end date of study drug was used for analysis. If participants started to take the study drug in the morning (early or on 12:00 PM), only then the evening PEF on the date of randomization was used. The outcome measure was considered missing if less than 2 days was recorded in the given treatment assessment period. Two participants from fluticasone propionate group and 5 participants from prednisone group had the missing outcome measure. Analysis was performed using an ANCOVA model with effects due to gender, age, centre and treatment group.

Time frame: Days 1/2 to 8

Population: ITT Population. Data is presented for the participants available at the time of assessment.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Fluticasone PropionateMean Evening PEF on Diary Card Over the Treatment Assessment Period195.79 L/minStandard Error 3.723
PrednisoneMean Evening PEF on Diary Card Over the Treatment Assessment Period194.63 L/minStandard Error 3.751
p-value: 0.82295% CI: [-9.02, 11.34]ANCOVA
Secondary

Mean Global Evaluation for Efficacy by Participant/Parent and Investigator

At Visit 3 (Day 8), participant/parent and investigator were asked to evaluate efficacy globally as very beneficial=1, beneficial=2, no effect=3 or worse=4. The global evaluation collected at the early withdrawal visit was included in the Visit 3. If participants were discontinued at Visit 2, then the global evaluation collected at the Visit 2 is also included in the Visit 3 for summary and analysis.

Time frame: Day 8

Population: ITT Population. Only those participants available at the specified time points were analyzed.

ArmMeasureGroupValue (MEAN)Dispersion
Fluticasone PropionateMean Global Evaluation for Efficacy by Participant/Parent and InvestigatorParticipant/parent global evaluation1.5 Scores on a scaleStandard Deviation 0.59
Fluticasone PropionateMean Global Evaluation for Efficacy by Participant/Parent and InvestigatorInvestigator global evaluation1.5 Scores on a scaleStandard Deviation 0.56
PrednisoneMean Global Evaluation for Efficacy by Participant/Parent and InvestigatorParticipant/parent global evaluation1.5 Scores on a scaleStandard Deviation 0.52
PrednisoneMean Global Evaluation for Efficacy by Participant/Parent and InvestigatorInvestigator global evaluation1.5 Scores on a scaleStandard Deviation 0.52
Comparison: Fluticasone propionate versus Prednisone for participant/parent global evaluationp-value: 0.633Wilcoxon rank sum test
Comparison: Fluticasone propionate versus Prednisone for investigator global evaluationp-value: 0.323Wilcoxon rank sum test
Secondary

Median Day-time and Night-time Symptom Scores Over the Treatment Assessment Period

The symptoms of cough, sputum production, wheeze and dyspnoea were assessed in morning and evening, and recorded on participant diary cards. Day-time symptoms were scored while retiring to bed on a scale of 0 (no symptoms) to 5 (severe). Night-time symptoms were scored while waking in the morning on a scale of 0 (no symptoms) to 4 (severe). For day-time score, only data that was from Days 2 to 8 after randomization and before or on the end date of study drug was used. For night-time score, only data that are from Days 2 to 8 after randomization and on or before one day after the end date of study drug was used. The outcome measure was considered missing if less than 2 days were recorded in the given treatment assessment period. The analysis only includes participants with at least 2 days of non-missing symptom scores in the given treatment assessment period.

Time frame: Days 2 to 8

Population: ITT Population. Only those participants available at the specified time points were analyzed.

ArmMeasureGroupValue (MEDIAN)
Fluticasone PropionateMedian Day-time and Night-time Symptom Scores Over the Treatment Assessment PeriodDay-time symptom score0.5 Scores on a scale
Fluticasone PropionateMedian Day-time and Night-time Symptom Scores Over the Treatment Assessment PeriodNight-time symptom score0.0 Scores on a scale
PrednisoneMedian Day-time and Night-time Symptom Scores Over the Treatment Assessment PeriodNight-time symptom score0.0 Scores on a scale
PrednisoneMedian Day-time and Night-time Symptom Scores Over the Treatment Assessment PeriodDay-time symptom score1.0 Scores on a scale
Comparison: Fluticasone propionate versus Prednisone for day-time symptom scorep-value: 0.717Wilcoxon rank sum test
Comparison: Fluticasone propionate versus Prednisone for night-time symptom scorep-value: 0.683Wilcoxon rank sum test
Secondary

Median Number of Use of Rescue Medications During Day and Night Over the Treatment Assessment Period

The use of nebulized salbutamol (doses/puffs and frequency) were recorded on diary card in the morning and evening. The median numbers of times of use of rescue medication during day and night was calculated for each participant over the treatment assessment period. In each case, only data that was from Days 2 to 8 after randomization and before or on the end date of study drug was used. The outcome measure was considered missing if less than 2 days (that is., 24-hour periods) were recorded in the given treatment assessment period. The analysis only includes participants who have at least 2 days of non-missing numbers of times rescue medication (including zero) in the given treatment assessment period.

Time frame: Days 2 to 8

Population: ITT Population. Data is presented for the participants available at the time of assessment.

ArmMeasureValue (MEDIAN)
Fluticasone PropionateMedian Number of Use of Rescue Medications During Day and Night Over the Treatment Assessment Period2.0 Number of use of rescue medication
PrednisoneMedian Number of Use of Rescue Medications During Day and Night Over the Treatment Assessment Period2.0 Number of use of rescue medication
p-value: 0.996Wilcoxon rank sum test

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026