Effectiveness of fluticasone furoate/vilanterol versus fluticasone propionate/salmeterol on asthma control in the Salford Lung Study

Abstract

Objective: The Asthma Salford Lung Study demonstrated the effectiveness of initiating once-daily fluticasone furoate/vilanterol (FF/VI) versus continuing usual care in asthma patients in UK primary care [1]. Here, we report a secondary analysis in a subset of patients with fluticasone propionate/salmeterol (FP/Salm) as their baseline intended maintenance therapy, to evaluate the relative effectiveness of initiating FF/VI versus continuing FP/Salm. Methods: Adults with symptomatic asthma were randomised to initiate FF/VI 100[200]/25 µg or continue FP/Salm. The Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), Work Productivity and Activity Impairment Asthma questionnaire, severe exacerbations, salbutamol inhaler prescriptions and serious adverse events (SAEs) were recorded throughout the 12-month treatment period. Results: One thousand two hundred and sixty-four patients (FF/VI 646; FP/Salm 618) were included in this subset analysis; 978 had baseline ACT score <20 and were included in the primary effectiveness analysis (PEA) population. At week 24, odds of patients being ACT responders (total score ≥20 and/or improvement from baseline ≥3) were significantly higher with FF/VI versus FP/Salm (71% vs. 56%; odds ratio 2.03 [95% CI: 1.53, 2.68]; p < 0.001 [PEA]). Significant benefit with FF/VI versus FP/Salm was also observed for AQLQ responders, activity impairment due to asthma, exacerbation rates, and salbutamol inhalers prescribed. No significant between-group differences were observed for impairment while working or work absenteeism due to asthma. Conclusions: For patients in primary care, initiating FF/VI was significantly better than continuing with FP/Salm for improving asthma control and quality of life, and reducing asthma exacerbations, with no notable difference in SAEs.

ClinicalTrials.gov: NCT01706198.

Keywords:

• randomised controlled trial
• real-world
• inhaled corticosteroid
• long-acting beta₂-agonist
• once-daily
• safety

Acknowledgements

Editorial support in the form of formatting, assembling tables and figures, collating author comments, grammatical editing and referencing was provided by Emma Landers, PhD, at Gardiner-Caldwell Communications (Macclesfield, UK) and was funded by GSK.

Declarations of interest

LJ, HS, JL-F, and DAL report employment with and stock/share ownership in GSK. NDB reports employment by the organisation that provided IT support for automated data collection in SLS (NorthWest EHealth) and receipt of financial support to attend meetings in the form of non-restricting educational grants from GSK, Novartis, AstraZeneca and Boehringer Ingelheim. JPN reports grants and personal fees from GSK.

Additional information

Funding

This analysis was sponsored by GSK (NCT01706198; GSK study HZA115150). The sponsors participated in the conception and design of the study, analysis and interpretation of the data, drafting and critical revision of the report, and approved submission of the manuscript. All authors had access to the results of the analyses, reviewed and edited the manuscript, approved the final draft, and were involved in the decision to submit the manuscript for publication. Seretide and ELLIPTA are trademarks owned by or licenced to the GSK group of companies.