This promotional video content was initiated and funded by GSK and is intended for healthcare professionals only.
Prescribing information for Relvar Ellipta (fluticasone furoate/vilanterol) is available below.
ERS 2024 GSK promotional symposium: watch the short summary videos with key highlights covered by the experts in their respective sessions. The expert sessions focused on the importance of timely assessments and explored how the balance of patient characteristics, molecular properties, and inhaler device choice impacts treatment outcomes, drawing on real-world evidence and the latest modelling studies.
Why Is Timely Assessment Critical for ICS/LABA Initiation in Moderate Asthma?
Real-world evidence suggests that there is a high proportion of patients living with asthma symptoms who are uncontrolled on current treatment.1
Timely assessment is key, particularly one that takes into consideration not only clinical measurements, but also personal circumstances and patient traits.2
It is important to address poor adherence, which can be as low as 50% in clinical practice, as well as patient inhaler preferences and inhaler characteristics.3-5
When presented with a patient whose asthma is uncontrolled on a regular inhaled corticosteroid (ICS), clinical measurements and personal characteristics can inform selection of the most appropriate ICS/long-acting β2-agonist (LABA) for them.*6
What Is the Right Balance to Look for While Selecting an ICS/LABA?
Not all ICSs are the same. Various molecular characteristics, such as glucocorticoid receptor binding and lung retention time, can differ substantially between molecules.7,8
Different ICSs provide different benefit-risk profiles in terms of their airway potency and systemic activity.9
RWE and recently published modelling data can help uncover important insights that help us appreciate the differences between the ICSs and their impact on patient outcomes.6,10
Finding the right balance when selecting an ICS/LABA should be informed by the molecular characteristics of their components, as well as varying patient characteristics.6-10
Choosing the First ICS/LABA for Your Patients: From Evidence to Practice
Asthma management should aim for the best outcomes for the patient, providing symptom control, minimising risk of outcomes including exacerbations and medication side effects, and other key targets such as helping them to achieve their personal goals.2
Inhaler selection and ensuring appropriate user technique is an important driver to help keep asthma controlled, which can impact patient adherence to maintenance ICS treatment.2
An appropriate treatment for patients with moderate asthma should aim to provide ‘balance’. It should address the asthma while considering a patient’s everyday life.2
Speakers:
Ashley Woodcock
Professor of Respiratory Medicine at The University of Manchester, UK; and Consultant Physician at The North West Lung Centre at Wythenshawe Hospital, Manchester, UK, which is home to the biggest lung centre in Europe.
Affiliations/Disclaimers
Professor of Respiratory Medicine, University of Manchester; Co-chair, Montreal Protocol Technology and Economic Assessment Panel Member; Medical Technical Options Committee Board; NW Lung Centre Charity; Co-chair, Moulton Charitable Trust; Consultant/travel support, GlaxoSmithKline and Orion; Chairman, Medicines Evaluation Unit; and Chairman/shareholder, Axalbion and Reacta Biotech.
Woodcock is receiving an honorarium from GSK for this presentation.
Dave Singh
Professor of Clinical Pharmacology and Respiratory Medicine at the University of Manchester, UK. He graduated in medicine from Cambridge University, UK, and then specialised in clinical pharmacology and respiratory medicine. His research interest is the development of new drugs for asthma and chronic obstructive pulmonary disease. He is the Medical Director of the Medicines Evaluation Unit, where he has acted as principal investigator in over 400 clinical trials. He is a member of the GOLD Science Committee. He was previously the Chair of the European Respiratory Society (ERS) airway pharmacology group. He is currently an Editor of the European Respiratory Journal and European Respiratory Review. He is a fellow of the European Respiratory Society and the British Pharmacology Society. He has over 450 publications.
Affiliations/Disclaimers
Singh has received personal fees from Adovate, Aerogen, Almirall, Apogee, Arrowhead, AstraZeneca, Bial, Boehringer Ingelheim, Chiesi, Cipla, CONNECT Biopharm, Covis, CSL Behring, DevPro Biopharma LCC, Elpen, Empirico, EpiEndo, Genentech, Generate Biomedicines, GlaxoSmithKline, Glenmark, Kamada, Kinaset Therapeutics, Kymera, Menarini, MicroA, OM Pharma, Orion, Pieris Pharmaceuticals, Pulmatrix, Revolo, Roivant Sciences, Sanofi, Synairgen, Tetherex, Teva, Theravance Biopharma, Upstream, and Verona Pharma.
Singh is receiving an honorarium from GSK for this presentation.
Christian Domingo
Master Consultant of Pulmonary Medicine at the Hospital de Sabadell (Corporació Parc Taulí, Sabadell, Barcelona, Spain); and Professor of Medicine at the Autonomous University of Barcelona, Spain. In the past he has been Professor of the Department of Anatomy and Physiology of the International University of Catalonia, Spain, and Professor of the Master in Health Economy of the University of Malaga, Spain. His research and publication interests include chronic obstructive pulmonary disease, oxygen therapy, non-invasive mechanical ventilation, and lung infections. In the last 20 years, he has mainly focused on severe asthma treatment and chronic cough. He has also published several papers on health economy and health management.
Affiliations/Disclaimers
Master Consultant of the Pulmonary Service, Responsible of the Severe Asthma Unit and Chronic Cough Unit, Corporació Sanitària Universitària Parc Taulí; Professor of Medicine, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Spain.
Domingo is receiving an honorarium from GSK for this presentation.
Disclaimer: This content has been created and reviewed by GSK to ensure compliance with the UK industry code of practice. Registration conditions differ internationally. Please refer to the label in your country for local prescribing information. This web page is intended for healthcare professionals only.’
*Based on findings from a recent clinical modelling and simulation study that quantified how individual baseline patient characteristics at the start of treatment influence response to regular maintenance medication. Using computer modelling and simulations based on data from individual patients enrolled in clinical trials of moderate-to-severe asthma (10 phase III/IV trials; n=10,456), the study predicted reliever inhaler use, asthma control, and risk of an exacerbation within the next 12 months. Simulation scenarios were then conducted to evaluate opportunities to improve and personalise real-life management of patients in clinical practice. Current smokers used nearly twice as many reliever canisters as patients who had never smoked, while former smokers used approximately 1.4 times more than never-smokers. Former smokers showed improvements in asthma control and reduced reliever use compared to current smokers; however, exacerbation rates remained similar regardless of smoking status. A history of ≥1 asthma exacerbation in the prior year was generally associated with reduced asthma control, increased reliever use, and markedly higher annualised exacerbation rates versus no asthma exacerbation history. However, there were no clear differences in symptom control or exacerbation rates according to asthma history. Reliever use followed a trend of increasing with longer asthma duration. Exacerbation rates and reliever use increased across higher BMI categories. Asthma control and reliever use remained relatively stable for patients with well-controlled and not well-controlled symptoms but worsened for patients with poorly controlled symptoms at baseline. Males had lower reliever use and exacerbation rates than females.6 Results cannot be extrapolated to clinical outcomes.
Relvar Ellipta is indicated for the regular treatment of asthma in adults and adolescents aged 12 years and older where use of a combination medicinal product (ICS/LABA) is appropriate in: Patients not adequately controlled with ICS and ‘as needed’ inhaled SABA and patients already adequately controlled on both an ICS and a LABA.
Prescribing information is available here for Relvar.
| Adverse events should be reported. Reporting form and information can be found at https://yellowcard.mhra.gov.uk or search for MHRA Yellowcard in the Google Play or Apple Store. Adverse events should also be reported to GSK on 0800 221 441 or mailto:[email protected]. |
PM-GBL-FFV-WCNT-240002
Date of preparation: December 2024
References
- Price D et al. Asthma control and management in 8,000 European patients: the REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Prim Care Respir Med. 2014;24:14009.
- Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention, 2024. Updated May 2024. Available at: https://ginasthma.org/2024-report/. Last accessed: 5 December 2024.
- Gaga M et al. Inhaler adherence in severe asthma: is there an electronic solution? Eur Respir J. 2018;51(1):1702219.
- Stoloff SW et al. Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies. J Allergy Clin Immunol 2004;113(2):245-51.
- Kerr PJ et al. Improving Medication Adherence in Asthma. Semin Respir Crit Care Med 2022;43(5):675-83.
- Paggiaro P et al. Baseline Characteristics and Maintenance Therapy Choice on Symptom Control, Reliever Use, Exacerbation Risk in Moderate–Severe Asthma: A Clinical Modelling and Simulation Study. Adv Ther. 2024;41(11):4065-88.
- Salter M et al. Pharmacological properties of the enhanced-affinity glucocorticoid fluticasone furoate in vitro and in an in vivo model of respiratory inflammatory disease. Am J Physiol Lung Cell Mol Physiol. 2007;293(3):L660-7.
- Daley-Yates PT. Inhaled corticosteroids: potency, dose equivalence and therapeutic index. Br J Clin Pharmacol. 2015;80(3):372-80.
- Daley-Yates PT et al. Therapeutic index of inhaled corticosteroids in asthma: a dose-response comparison on airway hyperresponsiveness and adrenal axis suppression. Br J Clin Pharmacol. 2021;87(2):483-93.
- Daley-Yates PT et al. Assessing the Effects of Changing Patterns of Inhaled Corticosteroid Dosing and Adherence with Fluticasone Furoate and Budesonide on Asthma Management. Adv Ther. 2023;40(9):4042-59.
