Subject: A multicentre, retrospective, observational, cross-sectional, survey study to analyse the role of Fluticasone Furoate and Vilanterol Powder for Inhalation in Asthma.

Asthma is a very common disease in worldwide population, in which almost 1 in 10 children and 1 in 12 adults are affected. According to Global Asthma Report 2018, 339 million people are affected worldwide.₁ Asthma is a chronic inflammatory disease characterized by bronchial hyper-reactivity (BHR) which leads to overproduction of mucus, airway narrowing and airway wall remodelling by reacting to non-specific stimuli (such as exercise and cold air) on smooth muscle cells in people with asthma.₂

According to GINA (Global Initiative for Asthma), the goal of treatment in ASTHMA is to: achieve total control and to reduce inflammation.³ Clinicians commonly use various pharmacological treatments in the management of asthma to relieve symptoms, improve quality of life, enhance exercise tolerance, prevent and treat exacerbations. The main strategy to be considered in the pharmacological treatment of asthma are bronchodilators; short-acting bronchodilators (β -agonist and anti- cholinergics) are given as first-line treatment and long-acting bronchodilators can be given in more symptomatic patients with greater functional impact.⁴

The Global Initiative for Asthma (GINA) and the National Asthma Education and Prevention Program (NAEPP) recommend a stepwise approach to achieve sufficient control of asthma, including reduction in the risk of exacerbations. If control is not achieved, an increase in controller therapy dose or the introduction of additional maintenance therapies are recommended.⁵

Fluticasone furoate/Vilanterol is a once-daily, fixed combination of an inhaled corticosteroid (ICS) and a long-acting β2-adrenoreceptor agonist (LABA), delivered via a dry powder inhaler. It is approved for the treatment of asthma and COPD and is the first once-daily ICS/LABA to be available for this indication. Fluticasone furoate is an enhanced-affinity glucocorticoid receptor agonist, with potent anti-inflammatory activity. Vilanterol produces rapid and prolonged bronchodilation. In phase III trials in adolescents and adults with various levels of asthma uncontrolled on ICS and/or ICS/LABA, fluticasone furoate/Vilanterol 100/25 or 200/25 mcg once daily significantly improved pulmonary function compared with placebo or equivalent dosages of fluticasone furoate alone (in some trials) or fluticasone propionate.

Below enlisted are the advantages of Fluticasone Furoate and Vilanterol in asthma:^5,6

First once-daily combination of ultra-long-acting inhaled β2-agonists and inhaled glucocorticoids

Vilanterol: Ultra-long acting (ULABA)

FF is structurally distinct from fluticasone propionate (FP) & has both greater affinity for glucocorticoid receptor and longer retention in respiratory tissues than FP

Great potential to improve compliance to long-term regular inhaled therapy

To improve the natural history and prognosis of asthma patients