Once-daily fluticasone furoate/vilanterol <i>versus</i> twice-daily fluticasone propionate/salmeterol in patients with asthma well controlled on ICS/LABA

Bernstein, David I.; Andersen, Leslie; Forth, Richard; Jacques, Loretta; Yates, Louisa

doi:10.1080/02770903.2017.1386214

Cited by 12 publications

(5 citation statements)

References 12 publications

(18 reference statements)

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“…In a double-blind randomised controlled trial (RCT), similar results for trough FEV 1 (19 mL) reported with FF/ VI (100/25 µg one time a day) compared with mediumdose FLU/SAL (250/50 µg two times a day) at week 24 in patients with persistent asthma already controlled on ICS/ LABA. 23 In this pooled analysis, the FEV 1 and PEF values (morning and evening) were improved with high-dose MF/ IND compared with high-dose FLU/SAL. ACQ-7 scores were improved from baseline in all treatment groups.…”

Section: Safetymentioning

confidence: 68%

One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies

Zyl-Smit

Máspero²,

Kerstjens

et al. 2021

BMJ Open Resp Res

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BackgroundDespite currently available standard-of-care inhaled corticosteroid (ICS)/long-acting β2-agonist therapies, a substantial proportion of patients with asthma remain inadequately controlled. This pooled analysis evaluated efficacy and safety of mometasone furoate/indacaterol acetate (MF/IND) versus fluticasone propionate/salmeterol xinafoate (FLU/SAL) in patients with inadequately controlled asthma.MethodsThis analysis included patients from PALLADIUM (NCT02554786) and IRIDIUM (NCT02571777) studies who received high-dose MF/IND (320/150 µg) or medium-dose MF/IND (160/150 µg) one time a day or high-dose FLU/SAL (500/50 µg) two times a day for 52 weeks. Reduction in asthma exacerbations, improvement in lung function, asthma control, and safety were evaluated for 52 weeks.ResultsIn total, 3154 patients (high-dose MF/IND, n=1054; medium-dose MF/IND, n=1044; high-dose FLU/SAL, n=1056) were included. High-dose MF/IND showed 26%, 22% and 19% reductions in rate of severe, moderate or severe, and all (mild, moderate and severe) exacerbations versus high-dose FLU/SAL, respectively, over 52 weeks (all, p<0.05). High-dose MF/IND improved trough FEV1 versus high-dose FLU/SAL at weeks 26 (Δ, 43 mL, p=0.001) and 52 (Δ, 51 mL, p<0.001). Reductions in asthma exacerbation rate and improvement in trough FEV1 with medium-dose MF/IND were comparable with high-dose FLU/SAL over 52 weeks. All treatments improved Asthma Control Questionnaire-7 score from baseline to 52 weeks with no difference between treatments. Safety was comparable between high-dose MF/IND and high-dose FLU/SAL.ConclusionsOne time a day, single-inhaler, high-dose MF/IND reduced asthma exacerbations and improved lung function versus two times a day, high-dose FLU/SAL in patients with inadequately controlled asthma. Similarly, improved outcomes were seen with one time a day, medium-dose MF/IND and two times a day, high-dose FLU/SAL, but at a lower ICS dose.

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Section: Safetymentioning

confidence: 68%

One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies

Zyl-Smit

Máspero²,

Kerstjens

et al. 2021

BMJ Open Resp Res

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“…Another issue was the randomization process; Bernstein et al . 32 showed similar FEV 1 at baseline, but the mean FEV 1 in the low-dose ICS group significantly decreased after 4 weeks of treatment, which may represent baseline bias, and no such difference was observed in other studies 4 , 39 ; therefore, this study was excluded from the network analysis of FEV 1 to maintain the comparability among the inhaler therapies. Despite this bias of the study, the full network of FEV 1 could be constructed for the transparency of analysis (Supplementary Fig.…”

Section: Resultsmentioning

confidence: 86%

“…Until 2016, as-needed ICS/LABA was considered inferior to maintenance ICS 12 . However, after the inclusion of recent studies 4 – 7 , 32 , as-needed ICS/LABA showed a similar effect with low- and medium-dose maintenance ICS in preventing exacerbation. As-needed ICS/SABA was also tried in three studies 27 , 30 , 31 and had similar efficacy with low-dose ICS.…”

Section: Discussionmentioning

confidence: 92%

“…S6 . Medium-dose ICS was not included in the analysis because it could not be compared with other inhaler therapies due to inappropriate randomization in the relevant study, as previously mentioned 32 . As-needed SABA or LABA and as-needed ICS/LABA were inferior to low-dose ICS by − 0.11 (95% CI, − 0.12 to − 0.10) and − 0.05 of mean difference (95% CI, − 0.06 to − 0.04), respectively (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Comparative efficacy of inhalers in mild-to-moderate asthma: systematic review and network meta-analysis

Park

Huh

Lee

et al. 2022

Sci Rep

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The comparative effectiveness of different inhaler therapies in mild-to-moderate asthma remains unclear. To assess this, we performed a systematic review and network meta-analysis of randomized controlled trials on the use of inhalers for mild-to-moderate asthma by searching PubMed, Cochrane, and Embase. A total of 29 trials including 43,515 patients and 12 types of inhaler therapies were included. For the prevention of severe and moderate-to-severe exacerbations, inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) as maintenance and reliever (SMART) showed the highest rank for effectiveness. As-needed ICS/LABA or short-acting β2-agonist (SABA) was similar to low-dose ICS and superior to as-needed SABA or LABA for the prevention of severe and moderate-severe exacerbations. As for lung function (FEV1), low-dose ICS/LABA had the highest rank; as-needed ICS/LABA was inferior to regular low-dose ICS but superior to placebo. Higher-dose ICS had a superior effect on the Asthma Control Questionnaire (ACQ) scores, and as-needed ICS/LABA and as-needed SABA or LABA had lower ranks in p-rankogram than did the regular use of low-dose ICS. As-needed ICS with LABA or SABA was more effective than a similar dose of regular ICS for preventing exacerbation in mild-to-moderate asthma. As-needed ICS showed some weakness in improving lung function and controlling asthma symptoms.

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“…Fluticasone furoate‐vilanterol was non‐inferior to fluticasone propionate‐salmeterol. Both the fluticasone propionate‐salmeterol group and fluticasone furoate‐vilanterol group had a higher trough evening FEV1 than the ICS group, and no significant difference in FEV1 at 24 weeks between the fluticasone furoate‐vilanterol and fluticasone propionate‐salmeterol group (19mls, 95% CI −11–49) 37 …”

Section: Novel Management Approaches For Da and Stramentioning

confidence: 92%

Pediatric problematic severe asthma: Recent advances in management

Scotney

Burchett

Goddard

et al. 2021

Pediatric Allergy Immunology

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Asthma is a chronic airways disease with both immediate and longterm health implications, including death and permanent disability.The burden of asthma, both clinical and financial, is considerable, with more than 100,000 annual hospital admissions in the United Kingdom and an overall cost of more than £1 billion per annum to the NHS. 1 A significant proportion of these costs can be attributed to children with asthma, in particular, those with severe asthma, who utilize up to 50% of healthcare resources for asthma. In addition, pediatric severe asthma has long-term health consequences into adulthood, with longitudinal studies suggesting it predisposes for adult chronic obstructive pulmonary disease. 2 If management of pediatric severe asthma can be optimized, then some of these health burdens may be mitigated.Problematic severe asthma (PSA) is an all-encompassing definition used for children aged 6-16 years with a confirmed diagnosis of asthma who have persistent symptoms despite maximal conventional therapy. 3 In order to optimize the management of children with PSA, a thorough assessment must be undertaken by the multidisciplinary team (MDT)

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Once-daily fluticasone furoate/vilanterol versus twice-daily fluticasone propionate/salmeterol in patients with asthma well controlled on ICS/LABA

Abstract: FF/VI was non-inferior to FP/SAL for evening trough FEV at 24 weeks. These data suggest that patients well controlled on FP/SAL could step across to FF/VI without loss of control.

Cited by 12 publications

References 12 publications

One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies

One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies

Comparative efficacy of inhalers in mild-to-moderate asthma: systematic review and network meta-analysis

Pediatric problematic severe asthma: Recent advances in management

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