Effectiveness of Fluticasone Furoate/Vilanterol in COPD in clinical practice

Research output: Contribution to journalArticle

  • External authors:
  • David Leather
  • Nawar Diar Bakerly
  • John New
  • Martin Gibson
  • Sheila Mccorkindale
  • Susan Collier
  • Jodie Crawford
  • Lucy Frith
  • Catherine Harvey
  • Henrik Svedsater
  • Ashley Woodcock

Abstract

Background. Evidence for the management of chronic obstructive pulmonary disease (COPD) comes from closely monitored efficacy trials on patient groups selected on restricted entry criteria. There is a need for randomized trials closer to usual clinical practice.

Methods. In a randomized, controlled effectiveness trial, 2,799 patients with a general practitioner’s diagnosis of COPD were initiated on once-daily inhaled combination of 100 μg fluticasone furoate and 25 μg vilanterol (FF/VI) or usual care. The primary outcome was moderate-severe exacerbations in patients who had an exacerbation within 1 year before the study. Secondary outcomes were primary and secondary care contacts, modification to initial study COPD treatment, and time to exacerbations in patients who had an exacerbation within 3 years before the study.

Results. Compared with usual care, the rate of moderate-severe exacerbations was significantly reduced by FF/VI therapy, percent reduction 8.4% (95% confidence interval [CI] 1.1 to 15.2%, p=0.025). There was no difference in annual rate of COPD-related contacts to primary or secondary care. There was no difference in time to first moderate-severe exacerbation and time to first severe exacerbation between the FF/VI group vs. the usual care group. There were no excess serious adverse events of pneumonia in the FF/VI group. Other serious adverse events were similar between treatment arms.
Conclusion. In patients with a general practitioner’s diagnosis of COPD and a history of exacerbations, a simple once-daily treatment regimen of combined fluticasone furoate and vilanterol reduced exacerbations without increasing risk of serious adverse events compared to usual care.

The study is registered on clinicaltrials.gov as NCT01551758.

Bibliographical metadata

Original languageEnglish
Pages (from-to)1253-1260
Number of pages8
JournalThe New England journal of medicine
DOIs
StatePublished - 29 Sep 2016