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.