Is Trelegy (fluticasone furoate, umeclidinium, and vilanterol) an inhaled bronchodilator therapy?

From the Guidelines

Trelegy is indeed an inhaled bronchodilator therapy, as it contains two bronchodilator components: umeclidinium (a long-acting muscarinic antagonist or LAMA bronchodilator) and vilanterol (a long-acting beta-agonist or LABA bronchodilator). According to the guidelines from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society 1, inhaled bronchodilators, such as those found in Trelegy, are recommended for stable COPD patients with respiratory symptoms and FEV1 <60% predicted. The guidelines suggest that patients who benefit the most from inhaled bronchodilators are those with respiratory symptoms and airflow obstruction with an FEV1 less than 60% predicted.

Some key points to consider when prescribing Trelegy include:

• It is a combination medication containing three active ingredients: fluticasone furoate (an inhaled corticosteroid), umeclidinium (a LAMA bronchodilator), and vilanterol (a LABA bronchodilator)
• The two bronchodilator components work by relaxing the muscles around the airways but through different mechanisms
• The fluticasone component reduces inflammation in the lungs
• Patients should rinse their mouth after using Trelegy to prevent oral thrush, a potential side effect of the corticosteroid component
• Trelegy is typically prescribed as one inhalation daily for patients with COPD or asthma who need multiple medications to control their symptoms.

It's worth noting that while the guidelines provide recommendations for the use of inhaled bronchodilators in general, they do not specifically address the use of Trelegy. However, based on the components of Trelegy and the guidelines for inhaled bronchodilators, Trelegy can be considered a comprehensive inhaled bronchodilator therapy. As stated in the guidelines, clinicians should base the choice of medication on individual patient needs and preferences 1.

From the FDA Drug Label

Vilanterol is a LABA. Umeclidinium is a long-acting muscarinic antagonist, which is often referred to as an anticholinergic. The bronchodilation following inhalation of umeclidinium is predominantly a site-specific effect. The pharmacologic effects of beta2-adrenergic agonist drugs, including vilanterol, are at least in part attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of adenosine triphosphate (ATP) to cyclic-3′,5′-adenosine monophosphate (cyclic AMP) Increased cyclic AMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.

Trelegy is not mentioned in the provided text, however, ANORO ELLIPTA contains both umeclidinium (a long-acting muscarinic antagonist) and vilanterol (a LABA), which are both inhaled bronchodilators. Since Trelegy is not mentioned, we cannot draw any conclusions about it. However, the question seems to be related to the components of Trelegy, which are umeclidinium, vilanterol, and fluticasone. Given that umeclidinium and vilanterol are both inhaled bronchodilators, it is likely that Trelegy is an inhaled bronchodilator therapy as well, but this cannot be confirmed based on the provided text. 2

From the Research

Definition of Trelegy

• Trelegy Ellipta is a dry powder inhaler containing fluticasone furoate (inhaled corticosteroid [ICS]), vilanterol trifenatate (long-acting beta2 agonist [LABA]) and umeclidinium bromide (long-acting muscarinic antagonist [LAMA]) 3.

Components of Trelegy

• The components of Trelegy work together to provide bronchodilation and anti-inflammatory effects in the treatment of chronic obstructive pulmonary disease (COPD) 3, 4.

Mechanism of Action

• Umeclidinium, a component of Trelegy, is a long-acting muscarinic antagonist that helps to relax the airway muscles and improve lung function 4, 5.
• Vilanterol, another component of Trelegy, is a long-acting beta2 agonist that also helps to relax the airway muscles and improve lung function 3, 5.

Clinical Evidence

• Studies have shown that Trelegy is effective in improving lung function, reducing symptoms, and decreasing exacerbation frequency in patients with COPD 3, 6, 7.
• Trelegy has been compared to other inhalers, including tiotropium, and has been shown to have benefits in terms of reducing inpatient admissions and readmissions 7.