A new formulation of fluticasone propionate/salmeterol in a metered-dose inhaler (MDI HFA) allows for the reduction of a daily dose of corticosteroid and provides optimal asthma control - A randomized, multi-center, non-inferiority, phase IV clinical study

• Published in: Respiratory medicine 2021-01, Vol.176, p.106274-106274, Article 106274
• Main Authors: Kupczyk, Maciej, Majak, Paweł, Kuna, Piotr, Asankowicz-Bargiel, Beata, Barańska, Eliza, Dobek, Rafał, Garbicz, Sławomir, Jerzyńska, Joanna, Latos, Anna, Machowiak, Wojciech, Majorek-Olechowska, Bernadetta, Olech-Cudzik, Anna, Poziomkowska-Gęsicka, Iwona, Rulewicz-Warniełło, Mirosława, Świderska, Anna, Tarnowski, Michał, Kopyto, Przemysław
• Format: Article
• Language: English
• Subjects: Adverse events; Asthma; Corticoids; Corticosteroids; Drug dosages; Fluticasone; Glucocorticoids; Hoarseness; Inhalers; Lung; Physical activity; Propionic acid; Reduction; Respiratory function; Risk reduction; SABA; Salmeterol; Self-administration; Spirometry; Steroids
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2020.106274

Improvement of the delivery method of inhaled corticosteroids and subsequent dose reduction can minimize the risk of unfavorable outcomes while providing optimal asthma control. This randomized, multi-center, non-inferiority, phase IV clinical study compared the efficacy and safety of a new formulation of fluticasone propionate/salmeterol (250 μg/50 μg, twice daily) administered in a metered-dose inhaler hydrofluoroalkane (MDI HFA) with a dry-powder inhaler (DPI) containing fluticasone propionate/salmeterol (500 μg/50 μg, twice daily). Adults with asthma (n = 231) were randomly assigned to either the study group (treated for 12 weeks with fluticasone propionate/salmeterol MDI HFA) or a control group (treated for 12 weeks with fluticasone propionate/salmeterol DPI). Asthma symptoms, exacerbations, short-acting β2-agonist (SABA) use, physical activity, lung function, and general health status were assessed during four study visits. Compared with the reference drug, the study drug decreased the incidence of daytime and night-time asthma symptoms, asthma exacerbations, self-administration of SABA, and the limitation of physical activity. Comparable improvement in peak expiratory flow ([MDI HFA] from 6.2 ± 0.2 to 6.6 ± 0.2 l/s vs. [DPI] from 6.0 ± 0.2 to 6.9 ± 0.2 l/s; p > 0.05), forced expiratory volume in one second, and forced vital capacity were obtained in both groups. Significantly lower incidence of hoarseness was observed in the study group ([MDI HFA] 0.0% vs. [DPI] 2.8%; p = 0.0267); no major differences were found for other adverse events. Fluticasone propionate/salmeterol (250 μg/50 μg, twice daily) MDI HFA provides optimal asthma control and is non-inferior to fluticasone propionate/salmeterol (500 μg/50 μg, twice daily) DPI. [Display omitted] •The risk of inhaled corticosteroids side effects is dose- and inhaler-dependent.•MDI HFA allows to reduce by half the required dose of fluticasone compared to DPI.•Fluticasone propionate/salmeterol MDI HFA provides optimal asthma control.•MDI HFA decreased the incidence of hoarseness compared to DPI.