糠酸氟替卡松维兰特罗吸入粉用于治疗慢性阻塞性肺疾病。
Fluticasone furoate and vilanterol inhalation powder for the treatment of chronic obstructive pulmonary disease.
作者信息
Matera Maria Gabriella, Capuano Annalisa, Cazzola Mario
机构信息
Department of Experimental Medicine, Section of Pharmacology 'L. Donatelli', Centre of Excellence for Cardiovascular Diseases, Second University of Naples, Naples, Italy.
出版信息
Expert Rev Respir Med. 2015 Feb;9(1):5-12. doi: 10.1586/17476348.2015.986468. Epub 2014 Dec 6.
Fluticasone furoate/vilanterol (FF/VI) is a novel inhaled corticosteroid/long-acting β₂-agonist (ICS/LABA) fixed dose combination that, by simplifying the dosing schedule, allows, for the first time in a member of the ICS/LABA class, a shift from twice-daily to once-daily treatment. FF/VI is delivered via a novel, single-step activation, multi-dose dry powder inhaler for oral inhalation, Ellipta. Regrettably, there are no head-to-head trials that have shown superiority in the safety or efficacy of FF versus other ICSs, but evidence shows that VI has a quicker onset of effect versus salmeterol. However, the clinical utility of this effect in a maintenance medication is still questionable. Furthermore, benefits of FF/VI over twice-daily ICS/LABA comparator have not been shown yet and, in addition, its adverse event profile is generally consistent with the known class effects of an ICS/LABA fixed dose combination. In particular, there is an increase in the risk of pneumonia among patients treated with FF/VI relative to VI, mainly among those who benefit most from FF/VI. Nevertheless, the interesting pharmacological profiles of both FF and VI, the possibility that FF/VI can be administered once-daily, and the attractive characteristics of Ellipta are important features that could help FF/VI to be a successful combination in the treatment of chronic obstructive pulmonary disease.
糠酸氟替卡松/维兰特罗(FF/VI)是一种新型吸入性糖皮质激素/长效β₂受体激动剂(ICS/LABA)固定剂量复方制剂,通过简化给药方案,首次在ICS/LABA类别药物中实现了从每日两次给药转变为每日一次给药。FF/VI通过一种新型的单步启动、多剂量干粉吸入器(Ellipta)经口腔吸入给药。遗憾的是,尚无头对头试验表明FF在安全性或疗效上优于其他ICS,但有证据显示,与沙美特罗相比,VI起效更快。然而,这种效应在维持治疗药物中的临床实用性仍存在疑问。此外,尚未证明FF/VI相对于每日两次给药的ICS/LABA对照药物具有优势,而且其不良事件谱总体上与ICS/LABA固定剂量复方制剂已知的类别效应一致。特别是,与VI相比,接受FF/VI治疗的患者发生肺炎的风险增加,主要是在那些从FF/VI中获益最多的患者中。尽管如此,FF和VI有趣的药理学特性、FF/VI可每日一次给药的可能性以及Ellipta吸引人的特点,都是有助于FF/VI成为慢性阻塞性肺疾病治疗中成功复方制剂的重要特性。