A once-daily fixed-dose combination of inhaled corticosteroids (ICS) and long-acting Î²2-adrenoceptor agonist (LABA) significantly improved lung function over ICS alone, a phase III study has concluded (9 July 2020)
The participants were randomly assigned to either high- or medium-dose mometasone furoate plus indacaterol acetate (MF–IND) taken once daily; high- or medium-dose MF taken twice and once daily, respectively; or high-dose fluticasone propionate–salmeterol xinafoate (FLU–SAL) taken twice daily.
The researchers found that high- and medium-dose MF–IND showed superiority in improving trough FEV1, compared with corresponding MF doses from baseline at week 26. Furthermore, high-dose MF–IND was non-inferior to twice-daily high-dose FLU–SAL in improving trough FEV1 from baseline at week 26. These changes were sustained for the full 52 weeks of the study.
The researchers explained that the fixed-dose combination of ICS and LABA is the preferred step-up treatment option for patients with asthma that is inadequately controlled on ICS monotherapy.
“Once-daily MF–IND might be an effective treatment option in patients with inadequately controlled asthma, particularly in those patients who find a twice-daily treatment option to be burdensome,” they concluded.
 van Zyl-Smit R, KrÃ¼ll M, Gessner C et al. Once-daily mometasone plus indacaterol versus mometasone or twice-daily fluticasone plus salmeterol in patients with inadequately controlled asthma (PALLADIUM): a randomised, double-blind, triple-dummy, controlled phase 3 study. Lancet Respir Med 2020. doi: 10.1016/ S2213-2600(20)30178-8