An Indian Perspective on the Use of Fluticasone/Formoterol in Asthma and Chronic Obstructive Pulmonary Disease Patients

Abstract

Despite rapidly evolving health-care systems, India continues to have a high disease burden for asthma and chronic obstructive pulmonary disease (COPD). The Asia-Pacific Asthma Insights and Management survey clearly revealed that asthma management remains very poor with worst clinical outcomes in India. Potent inhaled corticosteroids (ICS) and quick onset of long-acting beta2-agonist (LABA) are considered to be optimal dual therapy for management of asthma and COPD. Fluticasone's long-term action against inflammation and formoterol's rapid long-term bronchodilator action are vital clinical attributes for optimal asthma maintenance treatment. In an 8- and 12-week trial, dual therapy of fluticasone and formoterol (FF) reported lung function improvements and better control of asthma than its monotherapy. A large clinical study revealed mild adverse events of dual FF than other dual ICS-LABA combinations. Recent pooled analysis of asthma showed that fluticasone shares a lower risk of pneumonia in asthma. Dual ICS-LABA therapies are preferred in COPD individuals with history of exacerbations. Numerous clinical studies showed significant efficacy, dose adjustments/switching, and safety outcomes with dual FF therapy in asthma and COPD. Dual FF inhaler therapy ensures highly potent anti-inflammatory activity and sustained bronchodilation, thus making this a preferred combination in terms of efficacy, safety, and patient adherence in asthma and COPD. This present review focuses on the combination therapy of formoterol and fluticasone for managing asthma and COPD.