Once- vs Twice-Daily Treatment for Controlled Asthma: Examining Outcomes

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All treatments were well-tolerated by study participants, with similar rates of on-treatment adverse events in all treatment groups.
All treatments were well-tolerated by study participants, with similar rates of on-treatment adverse events in all treatment groups.
The following article is part of conference coverage from the CHEST 2017 in Toronto, Canada. Visit Pulmonology Advisor's  conference page for more conference news.


TORONTO — Fluticasone furoate (FF)/vilanterol (VI) and fluticasone propionate (FP)/salmeterol (SAL) exhibit similar effects on 1-second evening trough forced expiratory volume (FEV1) in people with controlled asthma, according to findings presented at CHEST 2017, held October 28 to November 1 in Toronto, Ontario.

Participants with asthma controlled via twice-daily inhaled corticosteroid (ICS)/long acting β2-agonist (LABA) were included in this randomized, double-dummy trial. Patients first entered a LABA "washout" period for 5 days, taking only ICS during this time.

Those that achieved ≥150 mL improvement in FEV1 after salbutamol/albuterol were included in a 4-week run-in period, which included open-label 250/50 μg FP/SAL twice daily. Finally, patients who met the standards for control were randomly assigned to FF/VI 100/25 daily (n=504), FP/SAL 250/50 twice daily (n=501), or 24-week FP 250 twice daily (n=499).

A total of 1426 participants were included in the final analysis. At 24 weeks, investigators found no significant differences between the FF/VI 100/25 and FP/SAL 250/50 groups in terms of evening trough improvement. The investigators did find that evening trough FEV1 was significantly improved in both FF/VI (123 mL; P <.001) and FP/SAL (104 mL; P <.001) vs FP only.

In addition, researchers found comparable adjusted average changes in rescue-free periods of 24 hours for both FF/VI and FP/SAL (1.2%; 95% CI, −0.5 to 3.0). Compared with FP, FF/VI (P =.002) and FP/SAL (P =.106) increased rescue-free periods of 24 hours by 2.7% and 1.4%, respectively.

"This study demonstrates that patients whose asthma is currently well controlled on twice daily FP/SAL can step across to once daily FF/VI without loss of control," concluded the investigators.

Reference

Bernstein D, Forth R, Andersen LJ, Yates LJ, Jacques LA. Comparison of once daily fluticasone furoate (FF)/vilanterol (VI) with twice daily fluticasone propionate (FP)/salmeterol (SAL) in patients with controlled asthma. Presented at: CHEST 2017; October 28-November 1, 2017; Toronto, Ontario, Canada. Abstract 2735957.