Evaluating fluticasone furoate + vilanterol for the treatment of chronic obstructive pulmonary disease (COPD)

ABSTRACT

Introduction: Inhaled corticosteroid/long-acting β-2 agonists (ICS/LABA) combination inhalers have been a lifeline for a generation of chronic obstructive pulmonary disease (COPD) and asthma patients. Fluticasone furoate and Vilanterol (FF/VI) as a once-daily ICS/LABA combination have an extensive clinical trial and real-world data to support its use in COPD patients.

Areas covered: The authors provide pharmacological profiles of fluticasone furoate, vilanterol and the FF/VI fixed dose combination. Salient clinical trials evaluating efficacy and safety of the FF/VI combination, and studies demonstrating the impact on COPD exacerbation risk and mortality are also discussed.

Expert opinion: ICS/LABA combinations provide bronchodilation and decrease the frequency of COPD exacerbations. Individualizing treatment of each COPD patient based on unique phenotypes will maximize chances of therapeutic responsiveness. Asthma-COPD overlap (ACO), patients with sputum and/or blood eosinophilia, patients with a brisk bronchodilator response, and patients with frequent exacerbations are more likely to show a therapeutic response to ICS than populations who have none of these features. FF/VI will likely remain a popular ICS/LBA combination to treat COPD, as a once-daily inhaled therapy delivered via the Ellipta device popular with COPD patients, with extensive clinical trial and real-world data to support its use.

KEYWORDS:

• Chronic obstructive pulmonary disease
• fluticasone furoate
• vilanterol
• global initiative for obstructive lung disease
• exacerbations

Declaration of interest

C Lal has received grant support from Jazz Pharmaceuticals and Invado Pharmaceuticals and is a consultant for Jazz and Cipla Pharmaceuticals. C Strange has current, past, or pending grants in COPD from the Alpha-1 Foundation, Adverum, BTG, CSL Behring, Grifols, the National Institutes of Health, MatRx, Novartis, Pulmonx, Shire, and Vertex. He consults for AstraZeneca, Boehringer Ingelheim, CSL Behring, Grifols, and Uptake Medical on COPD. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Box 1. Drug summary box

Drug Name: Fluticasone furoate/Vilanterol

Phase: Launched

Indication: Chronic Obstructive Pulmonary Disease.

Pharmacology/Mechanism of action: Inhaled corticosteroid (anti-inflammatory) + Long acting β-2 agonist (bronchodilator)

Chemical structure:

Pivotal trials: NCT00731822, NCT01053988, NCT01054885, NCT01072149

Additional information

Funding

This manuscript has not been funded.