Genetic effects on efficacy to fluticasone propionate/salmeterol treatment in COPD

Purpose: No studies have investigated genetic effects on quality of life (QoL) measurements like improvements in the St George's Respiratory Questionnaire (SGRQ) scores for chronic obstructive pulmonary disease treatments with fluticasone propionate/salmeterol (FSC). Therefore, in addition to testing genetic effects on change from baseline in trough forced expiratory volume in 1 s (FEV₁), genetic associations that may predict SGRQ response to FSC treatment were investigated in this analysis.

Methods: This post hoc exploratory genome-wide genetic analysis included subjects from 10 clinical trials: NCT01772134, NCT01772147, NCT00633217, NCT01817764, NCT01879410, NCT01822899, NCT01323621, NCT01342913, NCT01323634, and NCT01706328. The Genetics Analysis Population (subjects who provided written consent, a blood sample for genetic research, and were successfully genotyped) included 2005/2900 subjects in the intent-to-treat sample, who received FSC, for testing association with change from baseline in trough FEV₁ and 1188/2005 subjects for testing SGRQ responses (change from baseline SGRQ score and categorical response by SGRQ score with Responders achieving >4 unit decrease at end of study treatment).

Main findings: One locus on chromosome 20 with seven variants with low minor allele frequencies significantly associated with change from baseline SGRQ score. The binary SGRQ response provided similar trends for association but did not attain genome-wide significance levels. No genetic association was detected with change from baseline in trough FEV₁.

Conclusions: Common variants are unlikely to play a role in response to FSC.