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A Clinical Study to Evaluate the Effect of the Connected Inhaler System (CIS) on Adherence to Maintenance Therapy in Poorly Controlled Asthmatic Subjects

An Open Label, Randomised, Parallel Group Clinical Study to Evaluate the Effect of the Connected Inhaler System (CIS) on Adherence to Relvar/Breo ELLIPTA Therapy, in Asthmatic Subjects With Poor Control

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03380429
Enrollment
437
Registered
2017-12-21
Start date
2018-01-31
Completion date
2019-01-24
Last updated
2021-04-12

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

Conditions

Asthma

Keywords

Connected Inhaler System, Metered Dose Inhaler, ELLIPTA, RELVAR/BREO, Dry Powder Inhaler, Salbutamol, Asthma

Brief summary

GlaxoSmithKline (GSK) in collaboration with Propeller Health has developed a sensor, which can clip on to the ELLIPTA® dry powder inhaler (DPI) and monitor the time and date that the ELLIPTA DPI cover is fully opened and closed. Additionally, a sensor will be attached to the rescue medication metered dose inhaler (MDI). The data from both sensors will be fed back to the subject via an application (app) on smart phone and will be reviewed by the subject's health care professional (HCP) via an online dashboard. The sensors, app, dashboard and systems to provide data comprise the CIS. This study will be the first to evaluate the effect of CIS on adherence to maintenance therapy in subjects with uncontrolled asthma. This is an open-label, randomized, parallel group study in asthmatic subjects currently on a fixed dose inhaled corticosteroid (ICS)/long-acting beta 2 agonist (LABA) maintenance therapy. Eligible subjects will receive RELVAR®/BREO® maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers during the run-in period, which may last for up to 3 months. Eligible subjects will then be randomized into five treatment arms depending on whether the data, from RELVAR/BREO ELLIPTA or RELVAR/BREO ELLIPTA and salbutamol MDI, is fed back to the subject or subject and HCP, or not at all. The treatment period for the study is approximately 6 months and there will be a follow-up period one week post last visit. The total duration of a subject in the study will be approximately 9 months. RELVAR, BREO and ELLIPTA are registered trademarks of GlaxoSmithKline group of companies.

Interventions

DRUGRELVAR/BREO

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

DRUGSalbutamol

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

DEVICEHCP Dashboard

The information from sensors will be reviewed by the HCP via an online dashboard.

DEVICESensors

Clip-on sensors will be fitted to electronically record the actuation data.

Sponsors

GlaxoSmithKline
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI. Clip-on sensors will be attached to both inhalers which will provide data on maintenance therapy and rescue medication use to the subjects and their HCP. Subjects will be randomized into five treatment arms in a ratio of 1:1:1:1:1 depending on whether the data, from RELVAR/BREO ELLIPTA or RELVAR/BREO ELLIPTA and salbutamol MDI, is fed back to the subject or subject and HCP, or not at all.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Subjects aged 18 years or older, at the time of signing the informed consent. * Subjects with documented physician diagnosis of asthma as their primary respiratory disease. * ACT score \<20 at screening visit. * Non-smokers (never smoked or not smoking for \>6 months with \<10 pack years history (Pack years = \[cigarettes per day smoked/20\] multiplied by number of years smoked). * Male or female subjects will be included. A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: (i) Not a woman of childbearing potential (WOCBP). (ii) A WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 5 days\] after the last dose of study treatment. * Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the consent form and protocol. * Subject understands and is willing, able, and likely to comply with study procedures and restrictions. * Subject must be able to read in a language supported by the smart phone app in their region. * Subject must have been on maintenance therapy (Fixed dose combination ICS/LABA) for 3 months, cannot have changed dose in the month prior to screening and be able to change to an equivalent dose of RELVAR/BREO for the duration of the study. Other background asthma medication such as anti-leukotrienes and oral corticosteroids are permitted provided the dose has been stable for 1 month prior to screening. * Subject must be able to change to Salbutamol/Albuterol MDI rescue for the duration of the study and judged capable of withholding albuterol/salbutamol for at least 6 hours prior to study visits. * Subject must have their own Android or iPhone operating system (IOS) smart phone and a data package suitable for the installation and running of the app and sending and receiving data. Data used by the CIS is approximately 1 megabyte (MB) per month as a maximum; this is less data than a 1 minute video streamed from YouTube (2MB). * Subjects must be willing and able to download the app on their personal smart phone and keep it turned on for the duration of the study. This will also require Bluetooth to be turned on for duration of the study. Subjects will also have to turn on mobile data for the app for the duration of study; unless travelling and when extra data roaming costs could be incurred. Inclusion criteria for randomization: * ACT score \<20 at randomization visit (visit 2).

Exclusion criteria

* Subjects with a known or suspected alcohol or drug abuse which in the opinion of the investigator could interfere with the subject's proper completion of the protocol requirement. * History of life threatening asthma: Defined as an asthma episode that required intubation and/or was associated with hypercapnea, respiratory arrest or hypoxic seizures within the last 6 months. * A lower respiratory tract infection within 7 days of the screening visit. * Concurrent diagnosis of chronic obstructive pulmonary disease (COPD) or other respiratory disorders including active tuberculosis, lung cancer, bronchiectasis, sarcoidosis, lung fibrosis, pulmonary hypertension, interstitial lung diseases or other active pulmonary diseases. * History of hypersensitivity/intolerance to any components of the study inhalers (example, lactose, magnesium stearate). In addition, subjects with a history of severe milk protein allergy that, in the opinion of the study physician, contraindicates participation will also be excluded. * Historical or current evidence of clinically significant or rapidly progressing or unstable cardiovascular, neurological, cardiovascular, neurological, renal, hepatic, immunological, endocrine (including uncontrolled diabetes or thyroid disease) or hematological abnormalities that are uncontrolled. Significant is defined as any disease that, in the opinion of the investigator, would put the safety of the subject at risk through participation, or which would affect the analysis if the disease/condition exacerbated during the study. * Subjects who have ever received treatment with biological based therapy example, omalizumab, mepolizumab, for asthma. * Subjects who have received an investigational drug and/or medical device within 30 days of entry into this study (Screening), or within five drug half-lives of the investigational drug, whichever is longer. * A subject will not be eligible for this study if he/she is an immediate family member of the participating investigator, sub-investigator, study coordinator, employee of the participating investigator, or any family member of a Propeller Health employee.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor for Arms; (Cohort 1: Data on Maintenance Use Supplied to Participant and HCP andCohort 5: no Data Supplied to Participant or HCP)Month 4 to Month 6Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 anti-meridiem (a.m.) each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Analysis was carried out by Analysis of Covariance (ANCOVA) model. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 4 and 6 was determined by the maintenance sensor daily adherence over the last three months of the study period (between months 4 to 6). The daily adherence to ELLIPTA maintenance therapy when both the participant and the HCP were supplied with data from the maintenance sensor (Cohort 1) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Secondary

MeasureTime frameDescription
Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance SensorMonth 1 to Month 3Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 1 and 3 was determined by the maintenance sensor daily adherence. The effect on daily adherence to maintenance therapy when maintenance data was supplied to both the participant and the HCP (Cohort 1), maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.
Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance SensorMonth 1 to Month 6Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 1 and 6 was determined by the maintenance sensor daily adherence. The effect on daily adherence to maintenance therapy when maintenance data was supplied to both the participant and the HCP (Cohort 1), maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.
Percentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication SensorMonth 4 to Month 6Data for rescue medication use was collected by the clip-on sensor for salbutamol MDI which records time and date when the MDI was actuated. Percentage of rescue free days were determined by the rescue sensor records of date, time and number of inhaler actuations. Least Square mean percentage of rescue free days between Months 4 and 6 when maintenance data was supplied to both the participant and the HCP (Cohort 1); maintenance data was only supplied to participants (Cohort 2); rescue and maintenance data were supplied to participant and HCP (Cohort 3) and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.
Number of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication SensorMonth 4 to Month 6Data for rescue medication use was collected by the clip-on sensor for salbutamol MDI which records time and date when the MDI was actuated. Total rescue use was determined by the rescue sensor records of date, time and number of inhaler actuations. The mean number of doses of rescue medicines between Months 4 and 6 when maintenance data was supplied to both the participant and the HCP (Cohort 1); maintenance data was only supplied to participants (Cohort 2); rescue and maintenance data were supplied to participant and HCP (Cohort 3) and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.
Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance SensorMonth 4 to Month 6Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 4 and 6 was determined by the maintenance sensor daily adherence over the last three months of the study period (between months 4 to 6). The effect on daily adherence to maintenance therapy when maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.
Percentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 6Month 6Percentage of participants attaining asthma control was defined as participants with an ACT total score \>=20 at Month 6. The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Percentage of participants who attained asthma control at Month 6 is presented.
Percentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 6Baseline and Month 6The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Percentage of participants with an increase from Baseline \>=3 in ACT total score at Month 6 is presented.
Percentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 6Baseline and Month 6The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Percentage of participants who had either an ACT total score of \>=20 and/or an increase from Baseline \>=3 in ACT total score at Month 6 is presented.
Change From Baseline in Asthma Control Test (ACT) Total ScoreBaseline and Month 6The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Change from Baseline was calculated as post-dose visit value minus the Baseline value.

Countries

Canada, Germany, Italy, Netherlands, Spain, United Kingdom, United States

Participant flow

Recruitment details

This was an open-label, randomized, multi-center, parallel group study to evaluate the effect of the connected inhaler system (CIS) on adherence to Relvar/Breo ELLIPTA therapy, in asthmatic participants (Par) with poor control.

Pre-assignment details

A total of 528 participants were screened and 437 participants were enrolled and randomized in this study.

Participants by arm

ArmCount
Cohort 1: Data on Maintenance Use Supplied to Par and HCP
Eligible participants received Relvar/Breo maintenance therapy at doses of 100/25 microgram (mcg) or 200/25 mcg per actuation administered via ELLIPTA dry powder inhaler (DPI), one inhalation once daily. Participants also received salbutamol rescue medication at dose of 100 mcg per actuation administered via metered dose inhaler (MDI), as and when required. Sensors were attached to both the inhalers to electronically record actuation data. Information from sensor attached to Relvar/Breo ELLIPTA was fed back to the participant via an application on smart phone and to the participant's healthcare professional (HCP) via an online dashboard.
87
Cohort 2: Data on Maintenance Use Supplied to Par
Eligible participants received Relvar/Breo maintenance therapy at doses of 100/25 mcg or 200/25 mcg per actuation administered via ELLIPTA DPI, one inhalation once daily. Participants also received salbutamol rescue medication at dose of 100 mcg per actuation administered via MDI, as and when required. Sensors were attached to both the inhalers to electronically record actuation data. Information from sensor attached to Relvar/Breo ELLIPTA was fed back to the participant only via an application on smart phone.
88
Cohort 3: Data on Maintenance and Rescue Use to Par and HCP
Eligible participants received Relvar/Breo maintenance therapy at doses of 100/25 mcg or 200/25 mcg per actuation administered via ELLIPTA DPI, one inhalation once daily. Participants also received salbutamol rescue medication at dose of 100 mcg per actuation administered via MDI, as and when required. Sensors were attached to both the inhalers to electronically record actuation data. Information from sensors attached to Relvar/Breo ELLIPTA and salbutamol MDI was fed back to the participant via an application on smart phone and to HCP via an online dashboard.
88
Cohort 4: Data on Maintenance and Rescue Use Supplied to Par
Eligible participants received Relvar/Breo maintenance therapy at doses of 100/25 mcg or 200/25 mcg per actuation administered via ELLIPTA DPI, one inhalation once daily. Participants also received salbutamol rescue medication at dose of 100 mcg per actuation administered via MDI, as and when required. Sensors were attached to both the inhalers to electronically record actuation data. Information from sensors attached to Relvar/Breo ELLIPTA and salbutamol MDI was fed back to the participant via an application on smart phone.
88
Cohort 5: No Data Supplied to Par or HCP
Eligible participants received Relvar/Breo maintenance therapy at doses of 100/25 mcg or 200/25 mcg per actuation administered via ELLIPTA DPI, one inhalation once daily. Participants also received salbutamol rescue medication at dose of 100 mcg per actuation administered via MDI, as and when required. Sensors were attached to both the inhalers to electronically record actuation data. Participants were provided with a home hub through which their data was uploaded during the study but the participants and their HCP were not able to view the data.
86
Total437

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004
Overall StudyAdverse Event11120
Overall StudyLack of Efficacy00021
Overall StudyLost to Follow-up02431
Overall StudyPhysician Decision01011
Overall StudyProtocol Violation10101
Overall StudyWithdrawal by Subject33521

Baseline characteristics

CharacteristicCohort 1: Data on Maintenance Use Supplied to Par and HCPCohort 2: Data on Maintenance Use Supplied to ParCohort 3: Data on Maintenance and Rescue Use to Par and HCPCohort 4: Data on Maintenance and Rescue Use Supplied to ParCohort 5: No Data Supplied to Par or HCPTotal
Age, Continuous46.7 Years
STANDARD_DEVIATION 15.79
47.0 Years
STANDARD_DEVIATION 14.7
47.8 Years
STANDARD_DEVIATION 15.28
47.8 Years
STANDARD_DEVIATION 13.23
47.2 Years
STANDARD_DEVIATION 15.91
47.3 Years
STANDARD_DEVIATION 14.95
Race/Ethnicity, Customized
AI or AN and Black or African American
0 Participants2 Participants0 Participants0 Participants0 Participants2 Participants
Race/Ethnicity, Customized
AI or AN and White- White/Caucasian/EH
0 Participants1 Participants0 Participants0 Participants0 Participants1 Participants
Race/Ethnicity, Customized
American Indian (AI) or Alaska native (AN)
1 Participants0 Participants0 Participants0 Participants2 Participants3 Participants
Race/Ethnicity, Customized
Asian-Central/South Asian Heritage
1 Participants3 Participants1 Participants2 Participants1 Participants8 Participants
Race/Ethnicity, Customized
Asian-East Asian Heritage
1 Participants0 Participants0 Participants0 Participants1 Participants2 Participants
Race/Ethnicity, Customized
Asian-SE AH and White- White/Caucasian/EH
0 Participants0 Participants0 Participants0 Participants1 Participants1 Participants
Race/Ethnicity, Customized
Asian-South East (SE) Asian Heritage (AH)
2 Participants2 Participants3 Participants2 Participants3 Participants12 Participants
Race/Ethnicity, Customized
Black or African American
10 Participants3 Participants8 Participants9 Participants4 Participants34 Participants
Race/Ethnicity, Customized
Native Hawaiian or other Pacific Islander
0 Participants1 Participants0 Participants0 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White-Arabic/North African heritage
0 Participants0 Participants0 Participants1 Participants1 Participants2 Participants
Race/Ethnicity, Customized
White-White/Caucasian/European Heritage (EH)
72 Participants76 Participants76 Participants74 Participants73 Participants371 Participants
Sex: Female, Male
Female
64 Participants54 Participants59 Participants60 Participants47 Participants284 Participants
Sex: Female, Male
Male
23 Participants34 Participants29 Participants28 Participants39 Participants153 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
0 / 870 / 880 / 880 / 880 / 86
other
Total, other adverse events
4 / 871 / 881 / 881 / 882 / 86
serious
Total, serious adverse events
2 / 871 / 882 / 881 / 884 / 86

Outcome results

Primary

Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor for Arms; (Cohort 1: Data on Maintenance Use Supplied to Participant and HCP andCohort 5: no Data Supplied to Participant or HCP)

Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 anti-meridiem (a.m.) each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Analysis was carried out by Analysis of Covariance (ANCOVA) model. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 4 and 6 was determined by the maintenance sensor daily adherence over the last three months of the study period (between months 4 to 6). The daily adherence to ELLIPTA maintenance therapy when both the participant and the HCP were supplied with data from the maintenance sensor (Cohort 1) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 4 to Month 6

Population: Intent-to-Treat (ITT) Population comprised of all randomized participants, excluding those who were randomized in error. Only those participants with adherence data observed/imputed at the specified time points were analyzed.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor for Arms; (Cohort 1: Data on Maintenance Use Supplied to Participant and HCP andCohort 5: no Data Supplied to Participant or HCP)80.9 Percentage of ELLIPTA dosesStandard Error 3.19
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor for Arms; (Cohort 1: Data on Maintenance Use Supplied to Participant and HCP andCohort 5: no Data Supplied to Participant or HCP)69.0 Percentage of ELLIPTA dosesStandard Error 3.19
p-value: <0.00195% CI: [5.2, 18.8]ANCOVA
Secondary

Change From Baseline in Asthma Control Test (ACT) Total Score

The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Change from Baseline was calculated as post-dose visit value minus the Baseline value.

Time frame: Baseline and Month 6

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

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPChange From Baseline in Asthma Control Test (ACT) Total Score3.4 Scores on a ScaleStandard Error 0.4
Cohort 5: No Data Supplied to Par or HCPChange From Baseline in Asthma Control Test (ACT) Total Score4.3 Scores on a ScaleStandard Error 0.4
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParChange From Baseline in Asthma Control Test (ACT) Total Score4.7 Scores on a ScaleStandard Error 0.41
Cohort 5: No Data Supplied to Par or HCPChange From Baseline in Asthma Control Test (ACT) Total Score4.2 Scores on a ScaleStandard Error 0.41
Cohort 5: No Data Supplied to Par or HCPChange From Baseline in Asthma Control Test (ACT) Total Score3.9 Scores on a ScaleStandard Error 0.4
p-value: 0.495% CI: [-1.6, 0.6]MMRM
p-value: 0.44195% CI: [-0.7, 1.5]MMRM
p-value: 0.16495% CI: [-0.3, 1.9]MMRM
p-value: 0.66195% CI: [-0.9, 1.4]MMRM
Secondary

Number of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor

Data for rescue medication use was collected by the clip-on sensor for salbutamol MDI which records time and date when the MDI was actuated. Total rescue use was determined by the rescue sensor records of date, time and number of inhaler actuations. The mean number of doses of rescue medicines between Months 4 and 6 when maintenance data was supplied to both the participant and the HCP (Cohort 1); maintenance data was only supplied to participants (Cohort 2); rescue and maintenance data were supplied to participant and HCP (Cohort 3) and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 4 to Month 6

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

ArmMeasureValue (MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPNumber of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor55.3 Doses of rescue medicationStandard Deviation 107.73
Cohort 5: No Data Supplied to Par or HCPNumber of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor40.6 Doses of rescue medicationStandard Deviation 91.53
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParNumber of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor29.5 Doses of rescue medicationStandard Deviation 54.41
Cohort 5: No Data Supplied to Par or HCPNumber of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor27.0 Doses of rescue medicationStandard Deviation 45.27
Cohort 5: No Data Supplied to Par or HCPNumber of Doses of Rescue Medication Use Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor55.8 Doses of rescue medicationStandard Deviation 158.49
Secondary

Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor

Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 1 and 3 was determined by the maintenance sensor daily adherence. The effect on daily adherence to maintenance therapy when maintenance data was supplied to both the participant and the HCP (Cohort 1), maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 1 to Month 3

Population: ITT Population. Only those participants with adherence data observed/imputed at the specified time points were analyzed.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor85.7 Percentage of ELLIPTA dosesStandard Error 2.82
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor84.2 Percentage of ELLIPTA dosesStandard Error 2.66
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor82.0 Percentage of ELLIPTA dosesStandard Error 2.74
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor79.2 Percentage of ELLIPTA dosesStandard Error 2.78
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 3 as Determined by the Maintenance Sensor76.4 Percentage of ELLIPTA dosesStandard Error 2.82
p-value: 0.00395% CI: [3.2, 15.3]ANCOVA
p-value: 0.01195% CI: [1.8, 13.7]ANCOVA
p-value: 0.06695% CI: [-0.4, 11.4]ANCOVA
p-value: 0.35995% CI: [-3.1, 8.7]ANCOVA
Secondary

Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor

Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 1 and 6 was determined by the maintenance sensor daily adherence. The effect on daily adherence to maintenance therapy when maintenance data was supplied to both the participant and the HCP (Cohort 1), maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 1 to Month 6

Population: ITT Population. Only those participants with adherence data observed/imputed at the specified time points were analyzed.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor81.5 Percentage of ELLIPTA dosesStandard Error 3.07
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor78.8 Percentage of ELLIPTA dosesStandard Error 2.9
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor77.7 Percentage of ELLIPTA dosesStandard Error 2.99
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor75.2 Percentage of ELLIPTA dosesStandard Error 3.03
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 1 and Month 6 as Determined by the Maintenance Sensor71.8 Percentage of ELLIPTA dosesStandard Error 3.07
p-value: 0.00495% CI: [3.1, 16.3]ANCOVA
p-value: 0.03295% CI: [0.6, 13.5]ANCOVA
p-value: 0.0795% CI: [-0.5, 12.4]ANCOVA
p-value: 0.29495% CI: [-3, 9.9]ANCOVA
Secondary

Percentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor

Daily adherence is defined as the participant taking one dose of Relvar/Breo ELLIPTA, within a 24-hour period, starting at 12.00 a.m. each day of the treatment period. The percentage of ELLIPTA doses taken were determined by the clip-on sensor attached to ELLIPTA, which records the time and date when the ELLIPTA cover was opened and closed. Least Square mean percentage of ELLIPTA doses taken (daily adherence) between Months 4 and 6 was determined by the maintenance sensor daily adherence over the last three months of the study period (between months 4 to 6). The effect on daily adherence to maintenance therapy when maintenance data was only supplied to participants (Cohort 2), rescue and maintenance data were supplied to participant and HCP (Cohort 3), and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 4 to Month 6

Population: ITT Population. Only those participants with adherence data observed/imputed at the specified time points were analyzed.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor77.2 Percentage of ELLIPTA dosesStandard Error 3.04
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor78.3 Percentage of ELLIPTA dosesStandard Error 3.11
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor77.1 Percentage of ELLIPTA dosesStandard Error 3.25
Cohort 5: No Data Supplied to Par or HCPPercentage of ELLIPTA Doses Taken (Daily Adherence) Between Month 4 and Month 6 as Determined by the Maintenance Sensor69.0 Percentage of ELLIPTA dosesStandard Error 3.19
p-value: 0.01695% CI: [1.6, 14.9]ANCOVA
p-value: 0.00695% CI: [2.7, 16]ANCOVA
p-value: 0.01895% CI: [1.4, 14.8]ANCOVA
Secondary

Percentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 6

Percentage of participants attaining asthma control was defined as participants with an ACT total score \>=20 at Month 6. The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Percentage of participants who attained asthma control at Month 6 is presented.

Time frame: Month 6

Population: ITT Population

ArmMeasureValue (NUMBER)
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 652 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 666 Percentage of participants
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 655 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 653 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Attaining Asthma Control (Percentage of Participants With an ACT Total Score >=20) at Month 662 Percentage of participants
p-value: 0.38595% CI: [0.39, 1.44]Regression, Logistic
p-value: 0.51795% CI: [0.64, 2.42]Regression, Logistic
p-value: 0.92195% CI: [0.51, 1.85]Regression, Logistic
p-value: 0.32195% CI: [0.38, 1.38]Regression, Logistic
Secondary

Percentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 6

The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Percentage of participants who had either an ACT total score of \>=20 and/or an increase from Baseline \>=3 in ACT total score at Month 6 is presented.

Time frame: Baseline and Month 6

Population: ITT Population

ArmMeasureValue (NUMBER)
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 666 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 675 Percentage of participants
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 665 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 667 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants Who Have Either an ACT Total Score of >=20 and/or an Increase From Baseline >=3 in ACT Total Score at Month 670 Percentage of participants
p-value: 0.83395% CI: [0.48, 1.81]Regression, Logistic
p-value: 0.38395% CI: [0.69, 2.67]Regression, Logistic
p-value: 0.62895% CI: [0.44, 1.63]Regression, Logistic
p-value: 0.84495% CI: [0.49, 1.8]Regression, Logistic
Secondary

Percentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 6

The ACT is a validated self-completed questionnaire utilizing 5 questions to assess asthma control on a 5-point categorical scale ranging from 1 (not controlled at all) to 5 (completely controlled). Total score is calculated as the sum of the scores from the 5 questions and can range from 5 to 25, with higher scores indicating better control. An ACT total score of 5 to 19 suggests that the participant's asthma is unlikely to be well controlled, whilst a score of 20 to 25 suggests that the participant's asthma is likely to be well controlled. Baseline value was the latest assessment prior to randomization (Day 1, pre-dose). Percentage of participants with an increase from Baseline \>=3 in ACT total score at Month 6 is presented.

Time frame: Baseline and Month 6

Population: ITT Population

ArmMeasureValue (NUMBER)
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 661 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 669 Percentage of participants
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 665 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 663 Percentage of participants
Cohort 5: No Data Supplied to Par or HCPPercentage of Participants With an Increase From Baseline >=3 in ACT Total Score at Month 664 Percentage of participants
p-value: 0.91195% CI: [0.54, 1.98]Regression, Logistic
p-value: 0.38395% CI: [0.7, 2.54]Regression, Logistic
p-value: 0.81495% CI: [0.57, 2.04]Regression, Logistic
p-value: 0.98695% CI: [0.53, 1.89]Regression, Logistic
Secondary

Percentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor

Data for rescue medication use was collected by the clip-on sensor for salbutamol MDI which records time and date when the MDI was actuated. Percentage of rescue free days were determined by the rescue sensor records of date, time and number of inhaler actuations. Least Square mean percentage of rescue free days between Months 4 and 6 when maintenance data was supplied to both the participant and the HCP (Cohort 1); maintenance data was only supplied to participants (Cohort 2); rescue and maintenance data were supplied to participant and HCP (Cohort 3) and rescue and maintenance data only supplied to participant (Cohort 4) versus no data supplied to the participant or HCP (Cohort 5) is summarized.

Time frame: Month 4 to Month 6

Population: ITT Population. Only those participants with rescue data observed/imputed at the specified time points were analyzed.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Cohort 1: Data on Maintenance Use Supplied to Par and HCPPercentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor81.1 Percentage of rescue free daysStandard Error 2.82
Cohort 5: No Data Supplied to Par or HCPPercentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor81.2 Percentage of rescue free daysStandard Error 2.66
Cohort 4: Data on Maintenance and Rescue Use Supplied to ParPercentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor85.6 Percentage of rescue free daysStandard Error 2.76
Cohort 5: No Data Supplied to Par or HCPPercentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor83.7 Percentage of rescue free daysStandard Error 2.8
Cohort 5: No Data Supplied to Par or HCPPercentage of Rescue Free Days Between Month 4 and Month 6 as Determined by the Rescue Medication Sensor76.4 Percentage of rescue free daysStandard Error 2.82
p-value: 0.11895% CI: [-1.2, 10.8]ANCOVA
p-value: 0.10595% CI: [-1, 10.7]ANCOVA
p-value: 0.00295% CI: [3.3, 15.1]ANCOVA
p-value: 0.01595% CI: [1.5, 13.2]ANCOVA

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