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