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Mometasone/indacaterol inhaler bests fluticasone/salmeterol combo in difficult asthma: BMJ
Asthma is a prevalent chronic disease of the respiratory system and needs immediate care. Despite higher standard of care inhaled corticosteroid (ICS) or long-acting β2-agonist therapies, a substantial proportion of patients with asthma remain inadequately controlled.
A new study by Dr Kenneth Chapman and team revealed that high-dose mometasone furoate/indacaterol acetate (MF/IND) when used once a day reduced asthma exacerbations and improved lung function than fluticasone propionate/salmeterol xinafoate (FLU/SAL) that was used two times a day, in patients with inadequately controlled asthma.
The study demonstrates the superiority of a once-daily high-dose ICS-LABA formulation such as MF/IND as compared with twice-daily ICS-LABA as a potential treatment for asthma.
The study has been published in the journal BMJ Open Respiratory Research.
The objective of the study was to evaluate efficacy and safety of MF/IND versus FLU/SAL in patients with inadequately controlled asthma.
The study was an analysis including patients from palladium and iridium studies who received high-dose MF/IND (320/150 µg) or medium-dose MF/IND (160/150 µg) one time a day or high-dose FLU/SAL (500/50 µg) two times a day for 52 weeks. Reduction in asthma exacerbations, improvement in lung function, asthma control, and safety were evaluated for 52 weeks.
The results of the study were
• A total of, 3154 patients (high-dose MF/IND, n=1054; medium-dose MF/IND, n=1044; high-dose FLU/SAL, n=1056) were included.
• High-dose MF/IND showed 26%, 22% and 19% reductions in rate of severe, moderate or severe, and all (mild, moderate and severe) exacerbations versus high-dose FLU/SAL, respectively, over 52 weeks (all, p<0.05).
• High-dose MF/IND improved trough FEV1 versus high-dose FLU/SAL at weeks 26 (Δ, 43 mL, p=0.001) and 52 (Δ, 51 mL, p<0.001).
• Reductions in asthma exacerbation rate and improvement in trough FEV1 with medium-dose MF/IND were comparable with high-dose FLU/SAL over 52 weeks.
• All treatments improved Asthma Control Questionnaire-7 score from baseline to 52 weeks with no difference between treatments. Safety was comparable between high-dose MF/IND and high-dose FLU/SAL.
Dr Chapman and team concluded that when high-dose MF/IND used one time a day, single-inhaler, reduced asthma exacerbations and improved lung function compared to two times a day, high-dose FLU/SAL in patients with inadequately controlled asthma. Similarly, improved outcomes were seen with one time a day, medium-dose MF/IND and two times a day, high-dose FLU/SAL, but at a lower ICS dose.
Reference:
Medical Dialogues consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers. Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751