Long-term Benefits of Fluticasone Furoate Plus Vilanterol in Asthma Control

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Patients given fluticasone furoate plus vilanterol reported improvements in asthma symptoms per the Asthma Control Test.
Patients given fluticasone furoate plus vilanterol reported improvements in asthma symptoms per the Asthma Control Test.

A recent study published in The Lancet attempted to better characterize the efficacy of fluticasone furoate plus vilanterol in asthma control in clinical practice.

Using an open-label randomized controlled 2-arm effectiveness design, the Salford Lung Study  (An Effectiveness Study Comparing Fluticasone Furoate [FF, GW685698]/Vilanterol [VI, GW64244] With Standard Treatment in Asthma; ClinicalTrials.gov identifier: NCT01706198) was conducted at 74 general practice clinics in the United Kingdom. Investigators randomly assigned patients to treatment with fluticasone furoate plus vilanterol (n=2114) or usual care (n=2119). The primary outcome was the percentage of patients who scored ≥20 on an asthma control test (ACT) or an increase in ACT score from baseline of ≥3 (in patients who had scores <20) at 24 weeks.

At week 24, the odds of responding to treatment were higher in the fluticasone furoate plus vilanterol group, with a response rate of 71% compared with the usual care group (56%); (odds ratio, 2.00; 95% CI, 1.70-2.34; P <.0001). The adjusted mean ACT score increased 4.4 points from baseline in the intervention group  compared with 2.8 points in the usual care group (difference, 1.6; 95% CI, 1.3-2.0; P <.0001). Serious adverse events were comparable in both groups, and pneumonia was uncommon. The treatment benefit was consistent for the entire 52-week study duration.

Study limitations included the potential for bias due to the open-label design and the choice of a “soft” primary outcome such as the ACT score, which relies on patient perception. In addition, there was a large degree of treatment modification during the first 3 months in the fluticasone furoate and vilanterol group, primarily due to patients choosing to return to a long-standing treatment.

Nonetheless, given the enduring benefit observed in the intervention group, the findings suggest that patients in general practice with a diagnosis of symptomatic asthma can achieve improved asthma control from the use of once-daily combination therapy with fluticasone and vilanterol without incurring additional risk for serious adverse events.

Disclosures: The Salford Lung Study was funded by GlaxoSmithKline. Several investigators report financial support from GlaxoSmithKline as well as other pharmaceutical companies.

Reference

Woodcock A, Vestbo J, Bakerly ND, et al; on the behalf of the Salford Lung Study Investigators. Effectiveness of fluticasone furoate plus vilanterol on asthma control in clinical practice: an open-label, parallel group, randomised controlled trial [published online September 10, 2017]. Lancet. doi:10.1016/S0140-6736(17)32397-8

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