A once-a-day, high-dose combination mometasone furoate/indacaterol acetate (MF/IND) reduced asthma exacerbations and improved lung function to a greater degree than twice a day, high-dose fluticasone propionate/salmeterol xinafoate (FLU/SAL), according to the results of a recent study published in BMJ Open Respiratory Research.

Researchers examined the pooled results from the PALLADIUM (ClinicalTrials.gov Identifier: NCT02554786) and IRIDIUM (ClinicalTrials.gov Identifier: NCT02571777) studies evaluating patients with poorly controlled asthma to examine the effect of once per day MF/IND at high and medium dosage levels vs twice per day high-dose FLU/SAL. Outcomes of interest were asthma exacerbations, improvement in lung function, asthma control, and safety over a period of 52 weeks.

Among the 3154 patients included in the pooled analysis, 1054 received high-dose MF/IND (320/150 μg), 1044 received medium-dose MF/IND (160/150 μg), and 1056 received high-dose FLU/SAL (500/50 μg). When both high-dose therapies were compared, MF/IND showed 26%, 22% and 19% reductions in rates of severe, moderate or severe, and total exacerbations, respectively, over 52 weeks, compared with high-dose FLU/SAL. Furthermore, high-dose MF/IND improved trough forced expiratory volume in the first 1 second (FEV1) to a greater degree than high-dose FLU/SAL at 26 and 52 weeks.


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In comparing high-dose FLU/SAL with medium-dose MF/IND, researchers found comparable rates of reduction in asthma exacerbations and improvements in trough FEV1 over 52 weeks. Investigators found no significant differences between the 2 high-dose treatments in safety and no difference among the 3 therapies in Asthma Control Questionnaire-7 scores from baseline to 52 weeks.

The study authors concluded, “One time a day, single-inhaler, high dose MF/IND reduced asthma exacerbations and improved lung function versus 2 times a day, high-dose FLU/SAL in patients with inadequately controlled asthma.” These results support the use of MF/IND as a potential treatment option for inadequately controlled asthma that allows patients to use a lower dosage of inhaled corticosteroid, they added.

Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Chapman K, van Zyl-Smit R, Maspero J, et al. “One time a day mometasone/indacaterol fixed-dose combination versus two times a day fluticasone/salmeterol in patients with inadequately controlled asthma: pooled analysis from PALLADIUM and IRIDIUM studies.BMJ Open Respir Res. 2021;8(1):e000819. doi:10.1136/bmjresp-2020-000819

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