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


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:, ORCID: 
Address: 2/1, build. 1, Barrikadnaya Street, Moscow 123995, Russian Federation

Бионика Медиа