Edited by: Michael Wechsler
Modulation of allergen-induced bronchoconstriction by fluticasone furoate and vilanterol alone or in combination
Article first published online: 7 AUG 2013
© 2013 The Authors. Allergy published by John Wiley & Sons Ltd
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Volume 68, Issue 9, pages 1136–1142, September 2013
How to Cite
Modulation of allergen-induced bronchoconstriction by fluticasone furoate and vilanterol alone or in combination. Allergy 2013; 68: 1136–1142., , , , , , .
- Issue published online: 18 SEP 2013
- Article first published online: 7 AUG 2013
- Manuscript Accepted: 9 MAY 2013
- allergen challenge;
- inhaled corticosteroid;
- long-acting beta2-agonist
This placebo-controlled study assessed the effects of the once-daily inhaled corticosteroid (ICS) fluticasone furoate (FF) and long-acting beta2-agonist (LABA) vilanterol (VI) on early and late asthmatic responses (EAR/LAR) and airway hyper-responsiveness (AHR).
Patients (n = 27) were randomized to FF (100 μg), VI (25 μg), FF/VI (100/25 μg), and placebo for 21 days (four periods). Allergen challenge was performed 1 h post-dose on day 21. AHR was assessed on day 22 using methacholine.
Allergen challenge caused an early change (0–2 h) in minimum forced expiratory volume in 1 s (FEV1) of −1.091 l (95% CI: −1.344; −0.837) following placebo therapy; changes were −0.955 l (−1.209; −0.702), −0.826 l (−1.070; −0.581), and −0.614 l (−0.858; −0.370) following VI, FF, or FF/VI therapy, respectively. Treatment differences were significant for all comparisons between therapies. Mean changes in 0–2 h %FEV1 were as follows: −28.05 (placebo), −23.10 (VI), −22.33 (FF), and −16.10 (FF/VI). Following placebo, the late change (4–10 h) in weighted mean FEV1 was −0.466 l (−0.589; −0.343) and −0.298 l (−0.415; −0.181) after VI, and was +0.018 l with both FF/VI (−0.089; 0.124) and FF (−0.089; 0.125). Treatment differences were significant for all comparisons between therapies except FF/VI vs FF. Mean changes in 4–10 h %FEV1 were as follows: −21.08 (placebo), −14.30 (VI), −5.02 (FF), and −5.83 (FF/VI). AHR 24 h after allergen challenge was significantly reduced with FF/VI and FF vs placebo, and FF/VI was superior to either component.
Combined treatment with FF/VI provides additive protection from the EAR relative to its components, significant protection over VI alone from the LAR, and confers sustained protection from hyper-responsiveness 24 h post-dose.