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Open Access 01-12-2018 | Research

Anti-inflammatory duration of action of fluticasone furoate/vilanterol trifenatate in asthma: a cross-over randomised controlled trial

Authors: George Bardsley, Peter Daley-Yates, Amanda Baines, Rodger Kempsford, Mathew Williams, Tony Mallon, Irene Braithwaite, Kylie Riddell, Shashidhar Joshi, Philippe Bareille, Richard Beasley, James Fingleton, on behalf of the study team

Published in: Respiratory Research | Issue 1/2018

Abstract

Background

Fluticasone furoate/Vilanterol trifenatate (FF/VI) is an inhaled corticosteroid/long-acting beta-agonist combination with a prolonged bronchodilator duration of action. We characterised the time-course of onset and offset of airway anti-inflammatory action of FF/VI, as assessed by fraction of exhaled nitric oxide (FeNO), and compared this to the bronchodilator duration of action.

Methods

A single-centre, randomised, double-blind, placebo-controlled, two-period, crossover study was undertaken in 28 steroid-naïve adults with asthma. Participants with an FEV₁ ≥ 60% predicted, reversible airway disease, and FeNO > 40 ppb received FF/VI 100/25 mcg or placebo once daily for 14 days. FeNO and peak expiratory flow were measured twice-daily during treatment and during a 21-day washout period. FEV₁ was measured for five days from treatment cessation. The primary outcome measure was FeNO change from baseline ratio for 21 days following treatment cessation.

Results

In the 27 subjects who completed the study, median (range) baseline FeNO was 87 ppb (42–212). FF/VI 100/25 mcg reduced FeNO by day 3, ratio FF/VI versus placebo 0.72 (95% confidence interval 0.61–0.86) with the maximum reduction occurring at day 14, 0.32 (0.27–0.37). Following cessation of treatment FeNO remained suppressed for 18 days, ratio on day 18 0.77 (0.59–1.00), whereas improvements in FEV₁ and peak flow were maintained for 3 to 4 days post-treatment.

Conclusions

The anti-inflammatory duration of action of FF/VI is consistent with the high glucocorticoid receptor affinity and long lung retention of fluticasone furoate. The anti-inflammatory effect of FF/VI was of greater duration than its bronchodilator effect in adults with mild asthma.

Funding GlaxoSmithKline (201499).

Trial registration

Prospectively registered on ClinicalTrials.gov registry number NCT02712047.

Available only for authorised users

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Title: Anti-inflammatory duration of action of fluticasone furoate/vilanterol trifenatate in asthma: a cross-over randomised controlled trial
Authors: George Bardsley
Peter Daley-Yates
Amanda Baines
Rodger Kempsford
Mathew Williams
Tony Mallon
Irene Braithwaite
Kylie Riddell
Shashidhar Joshi
Philippe Bareille
Richard Beasley
James Fingleton
on behalf of the study team
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Respiratory Research / Issue 1/2018
Electronic ISSN: 1465-993X
DOI: https://doi.org/10.1186/s12931-018-0836-6

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Abstract

Background

Methods

Results

Conclusions

Trial registration

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