The Journal of Allergy and Clinical Immunology
Volume 124, Issue 6 , Pages 1217-1221, December 2009

Prolonged bronchoprotection against inhaled methacholine by inhaled BI 1744, a long-acting β2-agonist, in patients with mild asthma

  • Paul M. O'Byrne, MB, FRCP(C)

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
    • Corresponding Author InformationReprint requests: Paul M. O'Byrne, MB, FRCP(C), Department of Medicine, McMaster University Medical Center, 1200 Main St West, Hamilton, Ontario, Canada.
  • ,
  • Just van der Linde, MD

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Donald W. Cockcroft, MD, FRCP(C)

      Affiliations

    • University of Saskatoon, Saskatoon, Saskatchewan, Canada
  • ,
  • Gail M. Gauvreau, PhD

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • John D. Brannan, PhD

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Mark FitzGerald, MD, FRCP(C)

      Affiliations

    • University of British Columbia, Vancouver, British Columbia, Canada
  • ,
  • Richard M. Watson, BSc

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Joanne Milot, BSc

      Affiliations

    • Laval University, Quebec City, Quebec, Canada
  • ,
  • Beth Davis, PhD

      Affiliations

    • University of Saskatoon, Saskatoon, Saskatchewan, Canada
  • ,
  • Megan O'Connor, RN

      Affiliations

    • Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  • ,
  • Lorna Hart, PhD

      Affiliations

    • Boehringer Ingelheim Inc, Burlington, Ontario, Canada
  • ,
  • Lawrence Korducki, MSc

      Affiliations

    • Boehringer Ingelheim Inc, Burlington, Ontario, Canada
  • ,
  • Alan L. Hamilton, PhD

      Affiliations

    • Boehringer Ingelheim Inc, Burlington, Ontario, Canada
  • ,
  • Louis-Philippe Boulet, MD, FRCP(C)

      Affiliations

    • Laval University, Quebec City, Quebec, Canada

Received 14 July 2009; received in revised form 13 August 2009; accepted 18 August 2009.

Background

Long-acting ß2-agonists are an established controller medication in asthma. BI 1744 is a novel L\long-acting ß2-agonist with a preclinical profile that suggests 24-hour bronchodilation and bronchoprotection may be achieved.

Objective

To examine the bronchoprotective effects of single doses of BI 1744 against methacholine provocation in subjects with mild asthma.

Methods

Thirty-one subjects with mild asthma were randomized to receive single doses of BI 1744 (2, 5, 10, 20 μg) or placebo on separate days according to a double-blind, 5-way crossover design. Methacholine challenges were performed at 30 minutes and at 4, 8, 24, and 32 hours after each single dose of medication, and the results were expressed as PC20 FEV1.

Results

All doses of BI 1744 produced statistically significant increases in the methacholine PC20 compared with placebo as long as 32 hours. The mean (geometric SEM) methacholine PC20 24 hours after dosing with placebo was 1.73 (1.13) mg/mL, which increased after 2 μg to 3.86 (1.14) mg/mL, after 5 μg to 5.67 (1.14) mg/mL, after 10 μg to 9.42 (1.13) mg/mL, and after 20 μg to 13.71 (1.14) mg/mL (all P < .0001). After 32 hours, the methacholine PC20 value remained significantly increased for all doses. No safety or tolerability concerns were identified.

Conclusion

BI 1744 provides significant bronchoprotection against inhaled methacholine for up to 32 hours after single-dose administration.

Key words: Asthma, long-acting inhaled β2-agonists, methacholine, functional antagonists, bronchodilators

Abbreviations used: AE, Adverse event, LABA, Long-acting ß2-agonist

 

 Supported as part of the AllerGen Network of Centers of Excellence Clinical Investigator Collaborative and by Boehringer Ingelheim Inc.

 Disclosure of potential conflict of interest: P. M. O'Byrne is on the advisory board for AstraZeneca, GlaxoSmithKline, Topigen, Wyeth, and Schering; receives speakers' honoraria from AstraZeneca and GlaxoSmithKline; and receives research support from AstraZeneca, GlaxoSmithKline, Merck, Wyeth, Schering, and Alexion. D. W. Cockcroft received a travel grant from Merck; receives honoraria from GlaxoSmithKline; is a consultant for Pharmoxis; receives research support from AllerGen, Wyeth Pharmaceuticals, and Genentech; and is a member of the ATS, CTS, CSACI, ACAAI, and ACCP. G. M. Gauvreau receives honoraria from Boehringer Ingelheim and Schering Plough and research support from Schering Plough, MedImmune, and Genentech. M. FitzGerald is on advisory boards for GlaxoSmithKline, AstraZeneca, Novartis, Pfizer, Boehringer Ingelheim, Altana, Merck, and Topigen; is on the speakers' bureau for GlaxoSmithKline, AstraZeneca, Boehringer Ingelheim, Pfizer, and Merck; receives research support from CIHR, AstraZeneca, GlaxoSmithKline, Boehringer Ingelheim, Merck, Wyeth, Schering, Genentech, and Topigen; is a member of the GINA Executive Committee and CTS Asthma Committee; and is Chair of the GINA Science Committee. L.-P. Boulet is on advisory boards for AstraZeneca, Altana, GlaxoSmithKline, Merck Frosst, and Novartis; receives lecture fees from 3M, Altana, AstraZeneca, GlaxoSmithKline, Merck Frosst, and Novartis; receives research support from AstraZeneca, GlaxoSmithKline, Merck Frosst, Schering, 3M, Altana, AsthmaTx, Boehringer Ingelheim, Dynavax, Genentech, IVAX, MedImmune, Novartis, Roche, Topigen, and Wyeth; is an advisor for the Conseil du Medicament du Quebec; is a member of the Quebec Workmen Compensation Board Respiratory Committee; is chair of the Canadian Thoracic Society Guidelines Dissemination and Implementation Committee; is coleader of the Therapeutics Theme of the Canadian AllerGen Network of Centers of Excellence; is the holder of the Laval University Chair on Knowledge Transfer, Prevention, and Education in Respiratory and Cardiovascular Health; and is a member of the Asthma Committee of the World Allergy Organization. L. Hart, L. Korducki, and A. L. Hamilton are employed by Boehringer Ingelheim. The rest of the authors have declared that they have no conflict of interest.

PII: S0091-6749(09)01411-0

doi:10.1016/j.jaci.2009.08.047

The Journal of Allergy and Clinical Immunology
Volume 124, Issue 6 , Pages 1217-1221, December 2009