Citation Information :
Sarin BC, Grover S, Aulakh JK. To Study the Efficacy of FF/VI Combination in Adult Asthma Patients. Indian J Chest Dis Allied Sci 2024; 66 (4):118-123.
Background: Long-acting beta2-agonists (LABA) and inhaled corticosteroids require twice daily administration for effective treatment of bronchial asthma. This study aims to study the efficacy of fluticasone furoate/vilanterol (FF/VI) ICS/Ultra-LABA once-daily combination therapy in patients with bronchial asthma.
Materials and methods: This prospective observational study included 120 spirometry-diagnosed patients of bronchial asthma who were given FF/VI combination therapy and underwent follow-up at 2, 4, and 8 weeks of therapy. Patients were assessed during the follow-up period for the efficacy of therapy based on spirometric values.
Results: In the present study 61.7% were females and 38.3% were males. The commonest presenting symptom was cough present in 95% of patients followed by wheezing which was seen in 93.3% of patients and shortness of breath in 89.17% of patients. At 8 weeks of continuous therapy, only 5% of patients had a cough, 8.33% had wheezing and only 2.5% complained of shortness of breath. Forced expiratory volume (FEV) in one second (FEV1) at baseline, was 56.60 ± 1.26, and by the end of 8 weeks, it increased to 90.36 ± 11.38. Forced vital capacity (FVC) at baseline was 64.83 ± 12.63 and it increased to 91.8 ± 1035 at 8 weeks. Forced expiratory volume in one second (FEV1)/FVC at baseline was 63.31 ± 4.90 and it increased to 74.59 ± 3.19 at 8 weeks. Forced expiratory flow (FEF) 25–75% at baseline was 35.42 ± 14.74, and at 8 weeks of continuous therapy, it increased to 76.35 ± 8.85 and all these values were statistically significant (p < 0.05). The spirometric mean values were highly significant (p < 0.001) in between 2–4 weeks and 4–8 weeks.
Conclusion: Therapeutic continuity of FF/VI combination therapy is significantly effective in improving both symptoms and spirometric values in bronchial asthma patients. The safety profile and improvements in lung function irrespective of dosing time (morning or evening) strongly emphasize strict adherence to continuous once-daily use of the inhaler FF/VI to fully reverse the condition.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention; 2023. Available from: http://www.ginasthma.org.
Mortimer K, Lesosky M, García-Marcos L. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J 2022;60:2102865. DOI: 10.1183/13993003.02865-2021.
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:P1204–P1222. DOI: 10.1016/S0140-6736(20)30925-9.
Meghji J, Mortimer K, Agusti A. Improving lung health in low-income and middle-income countries: From challenges to solutions. Lancet 2021;397:928–940. DOI: 10.1016/S0140-6736(21)00458-X.
Lilburn PA, Ainge-Allen H, Thomas PS. Fluticasone furoate: A once daily preparation in patients with persistent asthma. J Lung Health Dis 2019;7:3. DOI: 10.29245/2689-999X/2018/1.1143.
Cazzola M, Rogliani P, Matera MG. Ultra-LABAs for the treatment of asthma. Respir Med 2019;156:47–52. DOI: 10.1016/j.rmed.2019.08.005.
Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: The global lung function 2012 equations. Eur Respir J 2012;40(6):1324–1343. DOI: 10.1183/09031936.00080312.
India State-Level Disease Burden Initiative CRD Collaborators. The burden of chronic respiratory diseases and their heterogeneity across the states of India: The Global Burden of Disease Study 1990–2016. Lancet Glob Health 2018;6:e1363–e1374. DOI: 10.1016/S2214-109X(18)30409-1.
Jindal SK, Aggarwal AN, Gupta D, et al. Indian study on the Epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Int J Tuberc Lung Dis 2012;16:1270–1277. DOI: 10.5588/ijtld.12.0005.
Singh S, Salvi S, Mangal DK, et al. Prevalence, time trends and treatment practices of asthma in India: The Global Asthma Network study. ERJ Open Res 2022;8(2):00528-2021. DOI: 10.1183/23120541.00528-2021.
Papi A, Blasi F, Canonica GW, et al. Treatment strategies for asthma: Reshaping the concept of asthma management. Allergy Asthma Clin Immunol 2020;16:1. DOI: 10.1186/s13223-020-00472-8.
Reddel HK, Taylor DR, Bateman ED, et al. American Thoracic Society/European Respiratory Society Task Force on Asthma Control and Exacerbations, An official American Thoracic Society/European Respiratory Society statement: Asthma control and exacerbations: Standardizing end points for clinical asthma trials and clinical practice. Am J Respir Crit Care Med 2009;180(1):59–99. DOI: 10.1164/rccm.200801-060ST.
Leynaert B, Sunyer J, Garcia-Esteban R, et al. Gender differences in prevalence, diagnosis and incidence of allergic and nonallergic asthma: A population-based cohort. Thorax 2012;67(7):625–631. DOI: 10.1136/thoraxjnl-2011-201249.
Singh AK, Cydulka RK, Stahmer SA, et al. Sex differences among adults presenting to the emergency department with acute asthma. Arch Intern Med 1999;159(11):1237–1243. DOI: 10.1001/archinte.159. 11.1237.
Boskabady MH, Rezaeitalab F, Rahimi N, et al. Improvement in symptoms and pulmonary function of asthmatic patients due to their treatment according to the Global Strategy for Asthma Management (GINA). BMC Pulm Med 2008;8:26. DOI: 10.1186/1471-2466-8-26.
Liu T, Valdez R, Yoon PW, et al. The association between family history of asthma and the prevalence of asthma among US adults: National Health and Nutrition Examination Survey, 1999–2004. Genet Med 2009;11(5):323–328. DOI: 10.1097/GIM.0b013e31819d3015.
Tanninen TH, Pelkonen AS, Malmberg LP, et al. Effect of fluticasone propionate/formoterol and fluticasone furoate/vilanterol on adolescents with chronic bronchial obstruction. J Allergy Clin Immunol 2024;3(3):100268. DOI: 10.1016/j.jacig.2024.100268.
O'Byrne PM, Bleecker ER, Bateman ED, et al. Once-daily fluticasone furoate alone or combined with vilanterol in persistent asthma. Eur Respir J 2014;43(3):773–782. DOI: 10.1183/09031936.00064513.
Dwan K, Milan SJ, Bax L, et al. Vilanterol and fluticasone furoate for asthma. Cochrane Database Syst Rev 2016(9):1–118. DOI: 10.1002/14651858.CD010758.pub2.
Busse WW, O‘Byrne PM, Bleecker ER, et al. Safety and tolerability of the novel inhaled corticosteroid fluticasone furoate in combination with the β2 agonist vilanterol administered once daily for 52 weeks in patients ≥12 years old with asthma: A randomised trial. Thorax 2013;68(6):513–520. DOI: 10.1136/thoraxjnl-2012-202606.
Woodcock A, Bleecker ER, Lötvall JH, et al. Efficacy and safety of fluticasone furoate/vilanterol compared with fluticasone propionate/salmeterol combination in adult and adolescent patients with persistent asthma: A randomized trial. Chest 2013;144(4):1222–1229. DOI: 10.1378/chest.13-0178.
Kempsford RD, Oliver A, Bal J, et al. The efficacy of once-daily fluticasone furoate/vilanterol in asthma is comparable with morning or evening dosing. Respir Med 2013;107(12):1873–1880. DOI: 10.1016/j.rmed.2013.07.002.