Fixed combination of vilanterol triphenatate/fluticasone furoate in the treatment of patients with bronchial asthma and chronic obstructive pulmonary disease: a literature review

A review of the literature selected from russian and foreign electronic medical libraries devoted to the use of a fixed combination of fluticasone furoate with vilanterol triphenatate (FF/VI) in the respiratory tract using a metered-dose powder inhaler in bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) is presented. (DPI) Ellipt. The results of studies of each of the components devoted to their clinical efficacy and safety, and the use of FF / VI in asthma and COPD are presented. Comparative randomized clinical trials have shown the advantages of FF / VI over the individual components of this combination and over other drugs. This combination was especially effective in AD. The economic efficiency of the transition of BA patients from everyday therapy to FF/VI has been proved. The data on the ability of the Ellipt DPI to form a clinically significant portion of the respirable fraction of both drugs, as well as data on the intuitive use of the device and adherence to the prescribed therapy are presented. In terms of the development of adverse events, the use of this combination in AD did not differ from placebo. With the use of FF/VI in patients with COPD, an increased incidence of pneumonia was noted, which was also typical for the use of FF alone, but did not accompany treatment with vilanterol. The analysis of the literature data based on well-planned multicenter RCTs with a large number of patients showed that the expansion of the use of a fixed combination of FF/VI in AD and COPD can improve control over these diseases and reduce the costs of practical healthcare, as well as preserve the level of treatment safety in comparison with monotherapy.

Combined therapy with inhaled glucocorticosteroids and long-acting β2-agonists in patients with bronchial asthma: the problem of choice

Bronchial asthma remains one of the most common chronic respiratory diseases. The apparent heterogeneity of BA underlies the concept of phenotype-specific or patient-centered therapy. However, in real clinical practice, BA continues to be regarded as a rather homogeneous pathological condition and its treatment in the vast majority of cases retains an empirical approach, the basis of which are inhaled glucocorticosteroids, usually in combination with long-acting beta2-agonists. Since this group of drugs is very representative, the physician is faced with the question of choosing the optimal drug. The basis of evidence-based medicine is a hierarchical classification, where systematic reviews, meta-analyses, and randomized clinical trials are considered the highest level of evidence. Because randomized clinical trials are conducted in carefully selected highly selected patient populations, they have little relevance to patients encountered in everyday clinical practice. In contrast, pragmatic randomized clinical trials assess the clinical efficacy of the investigational agent in a large, unselected population in which patients with comorbidities are included. In this context, the Salford Lung Study (SLS) is of particular interest. It was conducted before the registration of a new combination drug containing the modern ICS fluticasone furoate and the long-acting beta2-agonist vilanterol. The SLS results indicated not only that the use of fluticasone furoate with vilanterol provides better control of BA compared to continued "conventional therapy" (ICS ± LABAs) in symptomatic patients, but also leads to a consistent improvement in the surrogate parameters of quality of life.

Increased treatment adherence in patients with chronic obstructive pulmonary disease when using a fixed triple combination

Introduction. Poor medication adherence significantly increases the likelihood of complications, which leads to a decrease in quality of life (QoL) in patients and an increase in treatment costs.Goal. To study the adherence and effectiveness of treatment in COPD patients (group D) using a fixed triple combination of vilanterol/umeclidinium bromide/fluticasone furoate (FF/UMEC/VI).Material and methods. The study included 26 male patients with severe COPD with frequent exacerbations (group D). All patients were recommended therapy with a fixed triple combination of vilanterol/umeclidinium bromide/fluticasone furoate (FF/UMEC/VI). Patients were monitored for 12 months, and the following endpoints were recorded: hospitalization due to exacerbation of COPD, progression of COPD (decrease in FEV1), and death of the patient. In addition, the dynamics of treatment adherence, the number of SAT test scores, and the level of depression on the Beck scale were evaluated.Results. After 6 months of taking a fixed triple combination of FF/UMEC/VI, there was an improvement in treatment adherence in the form of a 15.3% decrease in the proportion of non-committed patients with COPD and an increase in the proportion of patients committed to therapy by 7.7%; the average frequency of exacerbations significantly decreased, this dynamics remained by the 12th month of follow-up. After 12 months, patients with COPD showed a statistically significant decrease in the proportion of patients who were not committed to treatment and a statistically significant increase in the proportion of patients who were committed to treatment for COPD; there was a statistically significant decrease in the frequency of severe depression in COPD patients; there was a statistically significant decrease in the proportion of patients with severe and moderate COPD influence on the quality of life.Conclusion. The results of our study confirmed the view that adherence plays a significant role in the effectiveness of treatment of COPD patients, and the use of a fixed triple combination of FF/UMEC/VI helps to increase it.

Applied Successful Treatment of Two Main Post-COVID-19 Symptoms: Anosmia and Ageusia: A Novel Approach

Patients recovering from COVID-19 occasionally reported anosmia (loss of smell) and ageusia (loss of taste). This paper aims to use medications to treat anosmia and ageusia in post-COVD-19 recovered patients. A total of 6391 recovered COVID-19 patients were invited to enroll in this study from all age groups, both genders and different health conditions (immunocompromised and immunocompetent patients). Clinical treatments of anosmia were done by application of Apisal nasal/eye drops (Amman Pharmaceutical Industries, Jordan), used 3 times a day to stimulate nasal epithelial lining cells. It can sensitize the nose then stimulate and induce smelling function. Responders were 2794 (43.72%) of patients who were cured and retained smelling (novel work). Next was application of Vicks inhaler nasal stick which consists of 125 mg menthol, 50 mg camphor and 10 mg Siberian pine needle oil used 3 times a day. Responders were 5884 (92.07%) within 5 days. A combination of Apisal and Vicks recorded 6186 (96.80%) cures. The rest, 205 non-responsive patients to above medications were prescribed Avamys (fluticasone furoate) 27.5 micrograms/spray, nasal spray suspension (GSK, UK), twice a day which gave 203 (99.02%) cures as this is a novel work. Clinical treatment of ageusia involved administration of A-Z vital caplets (Hansal, Germany), an excellent tonic (multivitamins and minerals) once a day for adults, while Pharmaton Kiddi syrup (Boehringer Ingelheim, Germany) was given to children. Hot spices included a mixture of equal volumes of black pepper, ginger, cinnamon, cloves and coriander (doses were not determined but little mixture powder was applied inside the mouth) were advised beside tonics to stimulate taste pads so as to gain its function back to normal. 6382 (99.80%) patients got their taste back to normal within 5 days and this is also a novel work. After massive success of these medications, they were circulated all over Arab homeland as well as expat Arabs across the world.