Fluticasone furoate and vilanterol inhalation powder for the treatment of chronic obstructive pulmonary disease

Expert Rev Respir Med. 2015 Feb;9(1):5-12. doi: 10.1586/17476348.2015.986468. Epub 2014 Dec 6.

Abstract

Fluticasone furoate/vilanterol (FF/VI) is a novel inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) fixed dose combination that, by simplifying the dosing schedule, allows, for the first time in a member of the ICS/LABA class, a shift from twice-daily to once-daily treatment. FF/VI is delivered via a novel, single-step activation, multi-dose dry powder inhaler for oral inhalation, Ellipta. Regrettably, there are no head-to-head trials that have shown superiority in the safety or efficacy of FF versus other ICSs, but evidence shows that VI has a quicker onset of effect versus salmeterol. However, the clinical utility of this effect in a maintenance medication is still questionable. Furthermore, benefits of FF/VI over twice-daily ICS/LABA comparator have not been shown yet and, in addition, its adverse event profile is generally consistent with the known class effects of an ICS/LABA fixed dose combination. In particular, there is an increase in the risk of pneumonia among patients treated with FF/VI relative to VI, mainly among those who benefit most from FF/VI. Nevertheless, the interesting pharmacological profiles of both FF and VI, the possibility that FF/VI can be administered once-daily, and the attractive characteristics of Ellipta are important features that could help FF/VI to be a successful combination in the treatment of chronic obstructive pulmonary disease.

Keywords: COPD; Ellipta; fixed-dose combination; fluticasone furoate; vilanterol.

Publication types

  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-2 Receptor Agonists / administration & dosage*
  • Adrenergic beta-2 Receptor Agonists / adverse effects
  • Androstadienes / administration & dosage*
  • Androstadienes / adverse effects
  • Animals
  • Benzyl Alcohols / administration & dosage*
  • Benzyl Alcohols / adverse effects
  • Bronchodilator Agents / administration & dosage*
  • Chlorobenzenes / administration & dosage*
  • Chlorobenzenes / adverse effects
  • Drug Administration Schedule
  • Drug Combinations
  • Dry Powder Inhalers
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Humans
  • Lung / drug effects*
  • Lung / physiopathology
  • Powders
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Treatment Outcome

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Androstadienes
  • Benzyl Alcohols
  • Bronchodilator Agents
  • Chlorobenzenes
  • Drug Combinations
  • Glucocorticoids
  • Powders
  • vilanterol
  • fluticasone furoate