Study To Evaluate Safety And Tolerability Of GSK256066 In Chronic Obstructive Pulmonary Disease (COPD) Patients

An AE was defined as any untoward medical occurrence (MO) in a participant temporally associated with the use of a medicinal product (MP), whether or not considered related to the MP and can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with its use. The SAE was any untoward MO that, at any dose, results in death, life threatening, persistent or significant disability/incapacity, results in or prolongs inpatient hospitalization, congenital abnormality or birth defect, that may not be immediately life-threatening or result in death or hospitalization but may jeopardize the participant or may require medical or surgical intervention.

ECG parameters consist of QT interval corrected by Bazett's (QTcB) and Fridericia's (QTcF) formulas, QT interval, QRS duration and PR interval. Baseline was defined as value at Day 0 (pre-bronchodilator). The change from Baseline was calculated by subtracting the Baseline values from the individual post-randomization values. Baseline was the mean of the 3 pre-salbutamol measurements at Day 0. It was assessed on Baseline, Day 1, 7, 14, 15, 21, 27 and 28. Post Baseline, ECG was performed 1-2 hours post dose.

ECG parameters consist of ventricular rate. The change from Baseline was calculated by subtracting the Baseline values from the individual post-randomization values. Baseline was the mean of the 3 pre-salbutamol measurements at Day 0. It was as/sessed on Baseline, Day 1, 7, 14, 15, 21, 27 and 28. Post Baseline, ECG was performed 1-2 hours post dose.

The PCI range for SBP was < 85 and > 160 millimeters of mercury (mmHg), DBP was < 45 and > 100 mmHg and for HR < 40 and > 110 beats per minute. It was assessed on Baseline (pre-bronchodilator), Day 14 and 27. Data for SBP high, SBP low, DBP high, DBP low, HR high and HR low is presented.

Clinical chemistry included: albumin, bicarbonate, alanine aminotransferase (ALT), albumin, alkaline phosphatase (ALP), aspartate aminotransferase (AST), blood urea, creatinine, magnesium, sodium, potassium, chloride, glucose, total bilirubin, direct bilirubin, indirect bilirubin, total protein, gamma glutamyltransferase (GGT), calcium, creatinine kinase, creatine kinase-MB, creatinine clearance (estimated; male and female), lactate dehydragenase, and troponin, triglycerides. Data for abnormal parameters (above and below range) is provided. It was assessed on Baseline (Day -3), Day 14, 28 and on follow up visit (Day 42). Data for only abnormal observations is presented.

Hematology included: haemoglobin, haematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell (RBC) indices, white blood cell (WBC), basophils, eosinophils, lymphocytes, monocytes, neutrophils and platelet count. Data for abnormal parameters (above and below range) is provided. It was assessed on Baseline (Day -3), Day 14, 28 and on follow up visit (Day 42). Data for only abnormal observations is presented.

Abnormal urinalysis data for RBC in urine and haematuria presented. Data for abnormal parameters (above and below range) is provided. It was assessed on Baseline (Day -3), Day 7, 14, 21, 28 and on follow up visit (Day 42). Data for only abnormal observations is presented.

The change from Baseline was calculated by subtracting the Baseline values from the individual post-randomization values. Baseline value defined as the value on Day 0. It was assessed on Baseline (Day 0), Day 14 and 27. Spirometry tests was performed before and 30 minutes after dosing with salbutamol (bronchodilator) on Day 0 and before dosing with GSK256066. As they were analyzed separately, there were two Baselines for these tests, 'pre bronchodilator Baseline' and 'post bronchodilator Baseline'. Smoking and short acting bronchodilators were avoided 6 hour prior to administration of the salbutamol. Observations with best test review (BTR) grading of 'not acceptable' were excluded.

Holter parameters were derived by visit over the 24 hour period as: maximum HR over 24 hours was the maximum HR of all time slices and mean HR over 24 hours was the mean HR of all time slices, weighted by the time length of each slice. The total number of ventricular runs and the number of supraventricular runs over 24 hours were derived by summing each count across all time slices. Data for normal, abnormal: not clinically significant and abnormal: clinically significant is presented. It was assessed on Baseline (Day 0), Day 14and 27. Data for normal, abnormal: clinically significant and abnormal: clinically not significant presented.

An exacerbation of COPD was defined as worsening of COPD symptoms requiring changes to normal treatment including antimicrobial therapy, short courses of oral steroids and other bronchodilator therapy. If clinically indicated, short-term treatment with antibiotics could be prescribed for the exacerbation. Any participants requiring treatment with inhaled or oral corticosteroids or admission to hospital were withdrawn from the study.

AUC0-last determined using the linear trapezoidal rule for increasing concentrations and the logarithmic trapezoidal rule for decreasing concentrations. AUC0-last for GSK256066 is presented. As GSK614917 concentrations were generally non-quantifiable, no summary statistics were derived for GSK614917 pharmacokinetic parameters due to the large number of missing values resulting from non-quantifiable concentration-time data. AUC(0-t) imputed with half lowest observed AUC(0-t) (half of 1.28 hour×picogram/ milliliters [mL]).

The first occurrence of the maximum observed concentration determined directly from the raw concentration-time data. Cmax for GSK256066 is presented. As GSK614917 concentrations were generally non-quantifiable, no summary statistics were derived for GSK614917 pharmacokinetic parameters due to the large number of missing values resulting from non-quantifiable concentration-time data. One pre-dose GSK614917 concentration at the Baseline visit which was >5% of the corresponding Cmax was excluded from the pharmacokinetic analysis. Cmax imputed with half lower limit of quantification (LLQ; half of 5 picogram/mL).

The tmax was the time at which Cmax was observed. Tmax was determined directly from the raw concentration-time data. Pharmacokinetic data of GSK256066 is presented. As GSK614917 concentrations were generally non-quantifiable, no summary statistics were derived for GSK614917 pharmacokinetic parameters due to the large number of missing values resulting from non-quantifiable concentration-time data.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. One participant had a total number of neutrophil cell/ mLs count of 0 which was imputed to 1. Data for adjusted geometric means of macrophages, neutrophils cells per mLs and total leukocyte count is presented as geometric mean. The change from Baseline was calculated by subtracting the Baseline values from the Day 28 values. Baseline was defined as the value at Day -3. Total number of cells per mL was calculated by percentage of cells divided by 100 multiplied by total leukocyte count. It was assessed on Baseline and Day 28.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. One participant had a total number of neutrophil cell/ mLs count of 0 which was imputed to 1. Data for adjusted means of percentage of total cells macrophages and neutrophils is presented as least square mean. The change from Baseline was calculated by subtracting the Baseline values from the Day 28 values. Baseline was defined as the value at Day -3. Percentage cells was calculated by absolute cell count divided by total non squamous cell count multiplied by 100. It was assessed on Baseline and Day 28.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. Data for adjusted means of percentage of total cells macrophages and neutrophils is presented as geometric mean. The change from Baseline was calculated by subtracting the Baseline values from the Day 28 values. Baseline was defined as the value at Day -3. Percentage cells was calculated by absolute cell count divided by total non squamous cell count multiplied by 100. It was assessed on Baseline and Day 28.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. One participant had a total number of neutrophil cell/ mLs count of 0 which was imputed to 1. Total number of cells per mL was calculated by percentage of cells divided by 100 multiplied by total leukocyte count. It was assessed on Baseline and Day 28. One participant had a total number of neutrophil cell/ mLs count of 0 which was imputed to 1.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. One participant had a total number of neutrophil cell/ mL count of 0 which was imputed to 1. Total number of cells per mL was calculated by percentage of cells divided by 100 multiplied by total leukocyte count. It was assessed on Baseline and Day 28.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. It was assessed on Baseline and Day 28. Values below LLQ or above upper limit of quantification (ULQ) was imputed to half the LLQ or ULQ, LLQs: total protein: 62.5 µg/mL and ULQ: total protein: 400 µg/mL. Adjusted mean values for current smokers and former smokers is presented as least square mean.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. It was assessed on Baseline and Day 28. Values below LLQ or above ULQ was imputed to half the LLQ or ULQ, LLQs: IL8: 70000 picograms/mL and ULQ: IL8: 360000 picograms/mL.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. It was assessed on Baseline and Day 28. Values below LLQ or above ULQ was imputed to half the LLQ or ULQ, LLQs: MPO: 90 nanograms/mL and ULQ: IL8: 5000 nanograms/mL.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. It was assessed on Baseline and Day 28. Data for adjusted mean is presented as least square mean.

Sputum was performed using ipratropium bromide. Participants must fast for 2 hour prior to the sputum induction (only water was allowed) and on Day 28 (Visit 6b), it was performed 2-4 hours after the final dose of study medication. It was assessed on Baseline and Day 28.

Spirometry tests was performed before and 30 minutes after dosing with salbutamol (bronchodilator) on Day 0 and before dosing with GSK256066. As they were analyzed separately, there were two Baselines for these tests, 'pre bronchodilator Baseline' and 'post bronchodilator Baseline'. Smoking and short acting bronchodilators were avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0), Day 14 and 27. Observations with BTR grading of 'not acceptable' were excluded.

Plethysmography procedures was performed 30 minutes after dosing with salbutamol and prior to dosing with GSK256066. Participants were resting in the body box for at least 1 minute prior to any assessments. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Data for adjusted mean is presented as least square mean.

Plethysmography procedures was performed 30 minutes after dosing with salbutamol and prior to dosing with GSK256066. Participants were resting in the body box for at least 1 minute prior to any assessments. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Data for adjusted mean is presented as least square mean.

Plethysmography procedures was performed 30 minutes after dosing with salbutamol and prior to dosing with GSK256066. Participants were resting in the body box for at least 1 minute prior to any assessments. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Data for adjusted mean is presented as least square mean.

IOS tests were performed prior to other measurements of pulmonary function to avoid any influence of forced expiratory manoeuvres on airway function during resting breathing. IOS test was performed before and 30 minutes after dosing with salbutamol and before dosing with GSK256066. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Observations with BTR grading of 'not acceptable' were excluded. Data for adjusted mean is presented as least square mean.

IOS tests were performed prior to other measurements of pulmonary function to avoid any influence of forced expiratory manoeuvres on airway function during resting breathing. IOS test was performed before and 30 minutes after dosing with salbutamol and before dosing with GSK256066. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Observations with BTR grading of 'not acceptable' were excluded. Data for adjusted mean is presented as least square mean.

IOS tests were performed prior to other measurements of pulmonary function to avoid any influence of forced expiratory manoeuvres on airway function during resting breathing. IOS test was performed before and 30 minutes after dosing with salbutamol and before dosing with GSK256066. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Observations with BTR grading of 'not acceptable' were excluded. The parameter 'R5-R15' was derived by subtracting R15 from R5 for each subject at each time point.

IOS tests were performed prior to other measurements of pulmonary function to avoid any influence of forced expiratory manoeuvres on airway function during resting breathing. IOS test was performed before and 30 minutes after dosing with salbutamol and before dosing with GSK256066. Smoking and short acting bronchodilators should be avoided 6 hour prior to administration of the salbutamol. It was assessed on Baseline (Day 0) and 27. Observations with BTR grading of 'not acceptable' were excluded.

Blood samples were collected to determine serum concentrations of inflammation biomarkers such as fibrinogen, tumour necrosis factor (TNF)-alpha, soluble TNF receptors (sTNF-Rs), IL-8, IL-6, IL-1-beta using an appropriately validated assay including ELISA and multiplex analysis. TNFα, sTNF-Rs, IL-8, IL-6 and IL-1-beta data were not collected. Values below LLQ or above ULQ have been imputed to half the LLQ or ULQ. LLQ for fibrinogen-0.4 grams per liter and ULQs for fibrinogen-14 grams per liter. Data for adjusted mean is presented as least square mean.

Blood samples were collected to determine serum concentrations of inflammation biomarkers such as fibrinogen, tumour necrosis factor-alpha (TNF-alpha), sTNF-Rs, IL-8, IL-6, IL-1-beta using an appropriately validated assay including ELISA and multiplex analysis. TNFα, sTNF-Rs, IL-8, IL-6 and IL-1-beta data were not collected. Surfactant protein D (SP-D) was collected. Values below LLQ or above ULQ have been imputed to half the LLQ or ULQ. LLQ for SP-D-7.8 nanograms per mL and ULQs for SP-D-2000 nanograms per mL. Data for adjusted mean is presented as least square mean.