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TRISTAR1 is a Chiesi funded Multinational, multicentre, randomised, open-label, active controlled, 26 week, 2-arm (Trimbow versus Relvar (fluticasone furoate/vilanterol) + Spiriva), parallel group study, it has not been peer reviewed.1,2

Study Design
Primary endpoint:
  • Change in baseline SGRQ total score at Week 26
    (Non-inferiority analysis: Trimbow vs Relvar + Spiriva)
Secondary endpoints included:
  • SGRQ response (change from baseline in total score ≤-4) at Week 26
  • FEV1 at Week 26
  • Male or female ≥40 years
  • COPD diagnosis ≥12 months prior to screening
  • FEV1, <50% + FEV1/FVC ratio <0.7
  • Current or ex-smokers with a history of ≥10 pack years
  • ≥1 exacerbation in the 12 months prior to screening
  • Symptomatic patient at screening with a CAT score ≥10
  • Dual therapy (ICS/LABA, LAMA/LABA, ICS+LAMA), or LAMA monotherapy, for at least 2 months prior to screening
  • Patients receiving triple therapy were excluded

Results1

TRISTAR met its primary endpoint of non-inferiority in mean change in SGRQ total score with Trimbow vs. Relvar + Spiriva; of note, pre-specified non-inferiority margins chosen were wide, and Relvar + Spiriva had numerically greater outcomes.

Mean change in SGRQ from baseline

At week 26, overall mean change in SGRQ total score from baseline was numerically greater with Relvar + Spiriva (overall mean difference: 1.04 units; 95% CI: -0.56, 2.65; p=0.204)

Mean change in SGRQ from baseline
Mean change in FEV1 from baseline

Adjusted mean change in FEV1 was greater with the Relvar and Spiriva treatment arm vs. the Trimbow arm (50ml; 95% CI: NR; p=NR). No statistical analysis for this end point

Mean change in FEV<sup>1</sup> from baseline

Safety1

TRISTAR: Trimbow and Relvar + Spiriva showed comparable safety profiles 1

Adverse events
Serious adverse events
References

(Links last checked July 2021)

  1. EU Clinical Trials Register. Available from: https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-001487-35/results
  2. Clinicaltrials.gov. Available from https://clinicaltrials.gov/ct2/show/NCT02467452
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