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Fluticasone furoate, umeclidinium bromide, and vilanterol as a combination therapy for chronic obstructive pulmonary disease.
Expert Rev Respir Med 2018; 12(12):997-1005ER

Abstract

Introduction: Triple therapy with two bronchodilators (LABA plus LAMA) and an inhaled corticosteroid (ICS) is recommended for patients suffering from severe chronic obstructive pulmonary disease (COPD). Areas covered: All 12-52 week-long studies comparing triple therapy with umeclidinium (UM) added to either fluticasone furoate/vilanterol (FF/VI) or fluticasone propionate/salmeterol (FP/SAL) vs. other comparators in COPD patients of group B or D (2011 GOLD classification) were considered. When UM was added to ICS/LABA with separate devices or within a single device, triple combination was more effective than comparators (usually, ICS/LABA combinations) regarding improvements to pulmonary function, symptoms, quality of life and, in the longer studies, rate of moderate-severe exacerbations. The IMPACT study (a large trial comparing UM/FF/VI with both FF/VI and UM/VI combinations) showed that triple therapy had a greater effect compared to dual therapies in reducing the rate of moderate-severe exacerbations, improving trough FEV1 and improving quality of life. The safety profile was good, without excess cardiovascular effects or pneumonia, however, the presence of comorbidities was frequent. Expert commentary: UM/FF/VI combination represents a good option for severe COPD patients who remain symptomatic and/or with frequent exacerbations despite dual therapies. Once daily administration with a simple and effective device may increase adherence and efficacy of the treatment.

Authors+Show Affiliations

a Department of Surgery, Medicine, Molecular Biology and Critical Care , University of Pisa , Pisa , Italy.b Bronchology and bronchial endoscopy unit, Department of medical specialties , S. Maria Annunziata hospital , Bagno a Ripoli (Florence) , Italy.a Department of Surgery, Medicine, Molecular Biology and Critical Care , University of Pisa , Pisa , Italy.a Department of Surgery, Medicine, Molecular Biology and Critical Care , University of Pisa , Pisa , Italy.a Department of Surgery, Medicine, Molecular Biology and Critical Care , University of Pisa , Pisa , Italy.a Department of Surgery, Medicine, Molecular Biology and Critical Care , University of Pisa , Pisa , Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30463451

Citation

Parri, Giulia, et al. "Fluticasone Furoate, Umeclidinium Bromide, and Vilanterol as a Combination Therapy for Chronic Obstructive Pulmonary Disease." Expert Review of Respiratory Medicine, vol. 12, no. 12, 2018, pp. 997-1005.
Parri G, Nieri D, Roggi MA, et al. Fluticasone furoate, umeclidinium bromide, and vilanterol as a combination therapy for chronic obstructive pulmonary disease. Expert Rev Respir Med. 2018;12(12):997-1005.
Parri, G., Nieri, D., Roggi, M. A., Vagaggini, B., Celi, A., & Paggiaro, P. (2018). Fluticasone furoate, umeclidinium bromide, and vilanterol as a combination therapy for chronic obstructive pulmonary disease. Expert Review of Respiratory Medicine, 12(12), pp. 997-1005. doi:10.1080/17476348.2018.1548936.
Parri G, et al. Fluticasone Furoate, Umeclidinium Bromide, and Vilanterol as a Combination Therapy for Chronic Obstructive Pulmonary Disease. Expert Rev Respir Med. 2018;12(12):997-1005. PubMed PMID: 30463451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fluticasone furoate, umeclidinium bromide, and vilanterol as a combination therapy for chronic obstructive pulmonary disease. AU - Parri,Giulia, AU - Nieri,Dario, AU - Roggi,Maria Adelaide, AU - Vagaggini,Barbara, AU - Celi,Alessandro, AU - Paggiaro,Pierluigi, Y1 - 2018/11/28/ PY - 2018/11/23/pubmed PY - 2019/10/8/medline PY - 2018/11/23/entrez KW - Chronic obstructive pulmonary disease (COPD) KW - fluticasone furoate KW - triple therapy SP - 997 EP - 1005 JF - Expert review of respiratory medicine JO - Expert Rev Respir Med VL - 12 IS - 12 N2 - Introduction: Triple therapy with two bronchodilators (LABA plus LAMA) and an inhaled corticosteroid (ICS) is recommended for patients suffering from severe chronic obstructive pulmonary disease (COPD). Areas covered: All 12-52 week-long studies comparing triple therapy with umeclidinium (UM) added to either fluticasone furoate/vilanterol (FF/VI) or fluticasone propionate/salmeterol (FP/SAL) vs. other comparators in COPD patients of group B or D (2011 GOLD classification) were considered. When UM was added to ICS/LABA with separate devices or within a single device, triple combination was more effective than comparators (usually, ICS/LABA combinations) regarding improvements to pulmonary function, symptoms, quality of life and, in the longer studies, rate of moderate-severe exacerbations. The IMPACT study (a large trial comparing UM/FF/VI with both FF/VI and UM/VI combinations) showed that triple therapy had a greater effect compared to dual therapies in reducing the rate of moderate-severe exacerbations, improving trough FEV1 and improving quality of life. The safety profile was good, without excess cardiovascular effects or pneumonia, however, the presence of comorbidities was frequent. Expert commentary: UM/FF/VI combination represents a good option for severe COPD patients who remain symptomatic and/or with frequent exacerbations despite dual therapies. Once daily administration with a simple and effective device may increase adherence and efficacy of the treatment. SN - 1747-6356 UR - https://www.unboundmedicine.com/medline/citation/30463451/Fluticasone_furoate,_umeclidinium_bromide,_and_vilanterol_as_a_combination_therapy_for_chronic_obstructive_pulmonary_disease L2 - http://www.tandfonline.com/doi/full/10.1080/17476348.2018.1548936 DB - PRIME DP - Unbound Medicine ER -