Combination therapy with inhaled glucocorticosteroids/long-acting beta-agonists in patients with bronchial asthma: choice of the best possible in real clinical practice


DOI: https://dx.doi.org/10.18565/pharmateca.2019.11.30-36

A.I. Sinopalnikov

Russian Medical Academy of Continuous Professional Education, Moscow
The basis for the treatment of bronchial asthma (BA) includes inhaled glucocorticosteroids (IGCS), usually in combination with long-acting β2-adrenoagonists (LABA) – IGCS/LABA. As this group of drugs becomes more and more representative over time, the practitioner often faces a difficult question about choosing the “best possible”. The main tool of evidence-based medicine is randomized clinical trials (RCTs), which do not always reflect real clinical practice. To this extent, the so-called pragmatic RCTs have no such disadvantage. One of them, the Salford Lung Study (SLS) is a 12-month phase III study to evaluate the efficacy and safety of the new combination drug containing modern IGCS fluticasone furoate (FF) and LABA vilanterol (VI) – 100 μg/25 μg or 200 μg/25 μg given once a day in the form of a multi-dose dry powder inhaler [23]. During the SLS, the therapeutic superiority of FF/VI over “conventional therapy” in achieving asthma control was demonstrated, and it was attributable to the clinical pharmacology features of the new combination of IGCS+LABA, including possibility of taking the drug once a day.
Keywords: bronchial asthma, inhaled glucocorticosteroids, long-acting β2-adrenoagonists, fluticasone furoate, vilanterol, pragmatic randomized clinical trials, Salford Lung Study

About the Autors


Corresponding author: Alexander I. Sinopalnikov, MD, Professor., Head of the Department of Pulmonology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; e-mail: aisyn@list.ru, ORCID: https://orcid.org/0000-0002-1990-2042 
Address: 2/1, build. 1, Barrikadnaya Street, Moscow 123995, Russian Federation


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