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Modulation of allergen‐induced bronchoconstriction by fluticasone furoate and vilanterol alone or in combination
Author(s) -
Oliver A.,
Bjermer L.,
Quinn D.,
Saggu P.,
Thomas P.,
Yarnall K.,
Lötvall J.
Publication year - 2013
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12205
Subject(s) - bronchoconstriction , medicine , asthma , fluticasone propionate , fluticasone , allergen , pharmacology , cardiology , allergy , immunology
Background This placebo‐controlled study assessed the effects of the once‐daily inhaled corticosteroid ( ICS ) fluticasone furoate ( FF ) and long‐acting beta 2 ‐agonist ( LABA ) vilanterol ( VI ) on early and late asthmatic responses ( EAR / LAR ) and airway hyper‐responsiveness ( AHR ). Methods 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. Results Allergen challenge caused an early change (0–2 h) in minimum forced expiratory volume in 1 s ( FEV 1 ) 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 % FEV 1 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 FEV 1 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 % FEV 1 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. Conclusion 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.