MedPath

Study finds no clinical advantage of budesonide inhaler over fluticasone in COPD

A recent study published in BMJ compared the effectiveness and safety of two single-inhaler triple therapies for COPD, finding that fluticasone-umeclidinium-vilanterol resulted in fewer COPD exacerbations compared to budesonide-glycopyrrolate-formoterol, without increasing the risk of pneumonia.

In a recent study published in [object Object], researchers from the United States and Canada investigated the comparative effectiveness and safety of two single-inhaler triple therapies for chronic obstructive pulmonary disease (COPD). The study focused on budesonide-glycopyrrolate-formoterol and fluticasone-umeclidinium-vilanterol in preventing COPD exacerbations and pneumonia hospitalizations in real-world settings.

Background

COPD is a progressive respiratory condition characterized by airflow limitations and exacerbations that worsen patients' quality of life and increase healthcare burden. Triple inhaler therapy, combining an inhaled corticosteroid with a long-acting beta-agonist and a long-acting muscarinic antagonist, has been recommended for certain patients to manage symptoms and prevent exacerbations.

About the Study

The study compared the effectiveness and safety of budesonide-glycopyrrolate-formoterol (administered twice daily through metered-dose inhalers) and fluticasone-umeclidinium-vilanterol (administered once daily using a dry powder inhaler) using real-world data from US health claims from 2021 to 2023. Participants were aged 40 years and older with a valid COPD diagnosis and were new users of either therapy.

Major Findings

The study found that fluticasone-umeclidinium-vilanterol resulted in fewer COPD exacerbations compared to budesonide-glycopyrrolate-formoterol. Among 20,388 matched pairs, the hazard of a moderate or severe exacerbation was 9% higher for budesonide-glycopyrrolate-formoterol users. However, the rate of hospitalization for pneumonia was identical between the two therapies.

Conclusions

The study concluded that fluticasone-umeclidinium-vilanterol triple inhaler therapy demonstrated a slight clinical advantage in preventing COPD exacerbations without increasing the risk of adverse events such as pneumonia. These findings support the use of dry powder inhalers as effective alternatives to metered-dose inhalers, aligning with efforts to reduce greenhouse gas emissions while maintaining patient care standards.
Journal reference:
  • Feldman, W. B., Suissa, S., Kesselheim, A. S., Avorn, J., Russo, M., Schneeweiss, S., & Wang, S. V. (2024). Comparative effectiveness and safety of single inhaler triple therapies for chronic obstructive pulmonary disease: new user cohort study. BMJ, 387.
doi:10.1136/bmj-2024-080409, https://www.bmj.com/content/387/bmj-2024-080409
Subscribe Icon

Stay Updated with Our Daily Newsletter

Get the latest pharmaceutical insights, research highlights, and industry updates delivered to your inbox every day.

Related Topics

Study on Inhaled Fexlamose for Treating Moderate to Severe COPD in Adults

A clinical trial is investigating the use of inhaled Fexlamose for treating adult participants aged 40 to 80 with moderate to severe COPD. The study focuses on individuals with a verified diagnosis of cigarette smoking-related COPD and specific spirometry performance criteria.

Fostamatinib Fails to Improve COVID-19 Recovery in Hospitalized Patients

A recent international trial found that fostamatinib, an immune-suppressing drug, did not significantly improve outcomes for hospitalized COVID-19 patients.
The study, involving 400 adults across 62 hospitals, measured oxygen-free days and mortality through day 28, showing no significant benefit from fostamatinib compared to a control group.

Fasenra Demonstrates Efficacy in Eosinophilic Asthma and COPD Exacerbations in Phase II Trial

A Phase II trial (ABRA study) showed that Fasenra, with or without prednisolone, significantly reduced exacerbations in eosinophilic asthma and COPD patients compared to prednisolone alone.
After 90 days, 45% of patients on Fasenra (with or without prednisolone) experienced exacerbations, versus 74% on prednisolone, indicating a substantial improvement with Fasenra.

Chiesi Farmaceutici's Inhaled PI3Kδ Inhibitor Suggests Target Unsuitability for COPD Management

Chiesi Farmaceutici disclosed CHF-6523, an inhaled PI3Kδ inhibitor, suggesting challenges in targeting PI3Kδ for COPD treatment.
AstraZeneca and Mitsubishi Tanabe are developing AZD4144, a clinical compound currently in Phase I trials in healthy volunteers.

Watchman FLX Superior to Anticoagulants for Stroke Risk Reduction Post-Cardiac Ablation

The OPTION trial demonstrated that Boston Scientific's Watchman FLX is superior to oral anticoagulation (OAC) in reducing bleeding events in patients post-cardiac ablation.
The study met its primary safety endpoint, showing Watchman FLX had significantly lower rates of major bleeding compared to OAC at 36 months.

GLORIOUS Trial: Exenatide and Restrictive Oxygenation Fail to Improve Outcomes in Cardiac Surgery

The GLORIOUS trial found that neither exenatide, a GLP-1 receptor agonist, nor restrictive oxygenation during cardiopulmonary bypass improved clinical outcomes after cardiac surgery.
The study, involving 1,389 patients, showed no reduction in mortality or morbidity from renal failure, stroke, or heart failure with either intervention.

Intratracheal Budesonide Fails to Improve Outcomes in Preterm Infants

A recent clinical trial found that intratracheal budesonide mixed with surfactant did not significantly improve survival free of bronchopulmonary dysplasia (BPD) in extremely preterm infants.
The study, involving 1059 infants born before 28 weeks' gestation, showed no clear difference in outcomes compared to surfactant-only treatment.

Vitamin D Supplementation Shows No Significant Benefit for COPD Management

A Cochrane review of 10 trials found that vitamin D supplementation does not reduce the rate of moderate or severe COPD exacerbations requiring systemic corticosteroids or antibiotics.
Vitamin D supplementation likely has no impact on lung function, as measured by FEV1 (% predicted), in COPD patients.

Inhaled Colistimethate Shows Promise for Bronchiectasis, Despite COVID-19 Impact

In the PROMIS-I trial, inhaled colistimethate sodium significantly reduced the mean annual exacerbation rate in bronchiectasis patients with _Pseudomonas aeruginosa_ infections.
The PROMIS-II trial, impacted by the COVID-19 pandemic, did not show a significant reduction in exacerbation rates with the same treatment.

Dupixent Shows Clinically Meaningful Benefit in COPD Patients with Type 2 Inflammation

Pooled analysis of BOREAS and NOTUS phase 3 trials reveals Dupixent significantly reduced COPD exacerbations by 31% over 52 weeks.
Dupixent improved lung function (FEV1) by 147 mL compared to 64 mL with placebo at 12 weeks, with sustained benefits observed at 52 weeks.

Reference News

[1]
Study finds no clinical advantage of budesonide inhaler over fluticasone in COPD
news-medical.net · Jan 6, 2025

Study compares budesonide-glycopyrrolate-formoterol and fluticasone-umeclidinium-vilanterol for COPD, finding fluticason...

© Copyright 2025. All Rights Reserved by MedPath
HomeTerms & ConditionsPrivacy Policy