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Fluticasone Furoate/Vilanterol: A Review of Its Use in Chronic Obstructive Pulmonary Disease

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Abstract

Fluticasone furoate/vilanterol (Relvar®, Breo®, Revinty®) is a fixed combination of a corticosteroid and a long-acting β2-adrenergic agonist (LABA) for once-daily use via a dry powder inhaler (Ellipta®). Fluticasone furoate/vilanterol 100/25 µg is approved for the treatment of chronic obstructive pulmonary disease (COPD) in several countries. This article reviews the clinical use of the combination in COPD and summarises pharmacological properties. Fluticasone furoate has enhanced affinity for the glucocorticoid receptor compared with other clinically used inhaled corticosteroids (ICS) and longer lung retention than fluticasone propionate. Vilanterol is highly selective for β2-adrenoreceptors and provides a rapid and prolonged duration of action. In phase 3 trials in patients with moderate to very severe COPD, overall, once-daily fluticasone furoate/vilanterol 100/25 µg improved pulmonary function more than placebo and fluticasone furoate alone and improved exacerbation rates more than vilanterol alone. With regard to pulmonary function, once-daily fluticasone furoate/vilanterol 100/25 μg was more effective than twice-daily fluticasone propionate/salmeterol 250/50 µg and similarly effective as twice-daily fluticasone propionate/salmeterol 500/50 μg. In 12-month trials, fluticasone furoate/vilanterol was generally well tolerated, and in 12- and 24-week trials, the incidence of adverse events was similar overall to that associated with the individual components or fluticasone propionate/salmeterol. However, as with the long-term use of all ICS agents, 12-month data indicate an increase in the risk of pneumonia with fluticasone furoate/vilanterol. In conclusion, fluticasone furoate/vilanterol is an effective and generally well tolerated additional LABA/ICS agent for the treatment of COPD with the added convenience of once-daily administration, which may improve treatment adherence in some patients.

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Disclosure

The preparation of this review was not supported by any external funding. Kate McKeage is a salaried employee of Adis/Springer. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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    Kate McKeage

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  1. Kate McKeage
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Correspondence to Kate McKeage.

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The manuscript was reviewed by: A.D. D’Urzo, Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada; A.F. Gelb, Department of Medicine, Lakewood Regional Medical Center, Lakewood, CA, and Geffen School of Medicine at UCLA Medical Centre, Los Angeles, CA, USA; E.M. Kerwin, Clinical Research Institute of Southern Oregon, Medford, OR, USA; D.M. Mannino, Department of Preventive Medicine, University of Kentucky College of Public Health, Lexington, KY, USA.

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McKeage, K. Fluticasone Furoate/Vilanterol: A Review of Its Use in Chronic Obstructive Pulmonary Disease. Drugs 74, 1509–1522 (2014). https://doi.org/10.1007/s40265-014-0269-6

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