Review Article

Inhaled Formoterol-Fluticasone Single Inhaler Therapy in Asthma: Real-World Efficacy, Budget Impact, and Potential to Improve Adherence

Table 1

Summary of clinical studies on the FF single inhaler.

Study/yearCountryNo. of subjects (n)DesignOutcome

Studies comparing switch in therapy of FF with salmeterol-fluticasone
Usmani et al. [25]England225A randomized, controlled, pragmatic, open-label trial on well-controlled asthmatic patientsIn patients with well-controlled asthma, a change from fluticasone-salmeterol to FF did not compromise asthma control. Step down of FF was well tolerated
Simon et al. [26]The UK2472A historical, matched cohort database study evaluated two treatment groups in the Optimum Patient Care Research Database in the UKChanging to, or initiating FF combination therapy, is associated with a noninferior proportion of patients who are severe exacerbation-free at a lower average annual cost compared with continuing or initiating treatment with fluticasone-salmeterol

Long-term real-world studies of efficacy and safety
Backer et al. [22]Czech republic, Denmark, France, Ireland, Norway, Slovak Republic, Sweden, and the United Kingdom2539A 12-month observational study of outpatients with asthmaIn this real-world postauthorization safety study, FF demonstrated a safety profile consistent with that seen in controlled clinical trials
Price et al. [23]/2019The UK41,609A historical, longitudinal cohort database study using UK primary care data from the Clinical Practice Research Datalink (CPRD) databaseFF was associated with an overall lower adverse outcome rate
Mansur et al. [24]Germany, Hungary, Poland, Romania, and the United Kingdom413An open-label study, mild to moderate-severe asthmaticsFF had a good safety and efficacy profile over the 6- and 12-month study periods

Budget impact analysis of FF
Emily et al. [27]The United KingdomReal-world analysisThe use of FF as an alternative to fluticasone-salmeterol can result in cost savings for the NHS when assessing drug
Dunlop et al. [28]The United KingdomReal-world analysisThe comparable efficacy and lower acquisition costs of FF compared with fluticasone-salmeterol make it a cost-saving option for the UK NHS for the treatment of asthma patients requiring combination maintenance therapy using a pMDI

Studies on FF using specialized inhalation devices
Ghoshal et al. [29]India385A prospective, open-label, noncomparative, real-world observational, 24-week, multicenter studyFF FDC capsules administered via a single-dose DPI, (Revolizer®) offer a novel, well-tolerated, and effective treatment option for the long-term management of asthma
Bell et al. [30]The United Kingdom307A randomized, open-label, two-period, crossover studyEase of use and preference data for FF pMDI challenged the perceived wisdom that DPI are necessarily simpler to use, whereas the corresponding data for FF K-haler strongly favoured this novel BTI over the Turbuhaler, Accuhaler, and other pMDIs