Novel once-daily fixed-dose ICS–LABA improves lung function over ICS monotherapy, research finds

A study in The Lancet Respiratory Medicine indicates that a once-daily fixed-dose combination of inhaled corticosteroids and long-acting β2-adrenoceptor agonist significantly improves lung function over inhaled corticosteroids alone.

Woman using an asthma inhaler

A once-daily fixed-dose combination of inhaled corticosteroids (ICS) and long-acting β2-adrenoceptor agonist (LABA) significantly improved lung function over ICS alone, a phase III study has concluded (9 July 2020)[1]
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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.

References

[1] van Zyl-Smit R, Krüll 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

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Citation
The Pharmaceutical Journal, PJ September 2020, Vol 305, No 7941;305(7941):DOI:10.1211/PJ.2020.20208280