Dose effect of once-daily fluticasone furoate in persistent asthma: A randomized trial

SummaryBackgroundThis randomized, double-blind, multicenter study was designed to evaluate the efficacy of inhaled once-daily fluticasone furoate (FF) administered in the evening in patients with persistent asthma not controlled by short-acting beta2 agonists, and to determine the dose(s) suitable for further development.MethodsOf 1459 patients screened, 598 received one of six treatments: placebo, FF (25 μg, 50 μg, 100 μg or 200 μg) once daily each evening, or fluticasone propionate (FP) 100 μg twice daily for 8 weeks. The primary endpoint was change from baseline in pre-dose evening forced expiratory volume in 1 s (FEV1).ResultsA dose–response effect was observed for once-daily FF 25–200 μg including (p < 0.001) and excluding placebo (p = 0.03). FF 50–200 μg once daily significantly increased FEV1 from baseline (p < 0.05 vs placebo), by >200 mL for FF 100 μg and 200 μg. Significant improvements were also achieved for peak expiratory flow, and percentage symptom-free and rescue-free 24 h periods. The magnitude of effect was at least as good as twice-daily FP. Overall, once-daily FF was well tolerated with no systemic corticosteroid effects.ConclusionFF 50–200 μg/day once daily in the evening demonstrated dose-related efficacy in asthma with 100–200 μg appearing to be the optimal doses for further evaluation.ClinicalTrials.gov: NCT00603382