From the Guidelines
Breo Ellipta (fluticasone furoate/vilanterol) is a recommended maintenance medication for asthma management, particularly for patients with moderate to severe persistent asthma who are not adequately controlled on a medium-dose inhaled corticosteroid alone. The most recent and highest quality study, 1, suggests that optimal asthma control can be achieved in approximately 70% of patients with a progressive increase in inhaled corticosteroid/long-acting b2 agonist therapy. Breo Ellipta, as a combination inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) therapy, is typically prescribed for these patients. The standard dosage is one inhalation (containing 100 or 200 mcg fluticasone furoate and 25 mcg vilanterol) once daily, which offers the convenience of 24-hour symptom control with a single daily dose.
Mechanism of Action
Breo Ellipta works through two complementary mechanisms:
- Fluticasone furoate reduces airway inflammation
- Vilanterol provides bronchodilation by relaxing airway smooth muscles. This dual action helps prevent asthma symptoms, reduce exacerbations, and improve lung function.
Usage and Side Effects
Patients should use Breo Ellipta regularly as prescribed, even when feeling well, as it is not intended for rescue therapy during acute symptoms. Common side effects may include:
- Throat irritation
- Headache
- Upper respiratory tract infections Patients should rinse their mouth after use to prevent oral thrush, a potential side effect of the corticosteroid component.
Clinical Recommendations
According to 1, inhaled corticosteroids are the most potent and consistently effective long-term control medication for asthma, and long-acting beta2 agonists are not recommended for use as monotherapy for long-term control of persistent asthma. The combination of ICS and LABA, such as Breo Ellipta, is a preferred treatment option for patients with moderate to severe persistent asthma who are not adequately controlled on a medium-dose inhaled corticosteroid alone.
Key Points
- Breo Ellipta is a recommended maintenance medication for asthma management
- It is typically prescribed for patients with moderate to severe persistent asthma
- The standard dosage is one inhalation once daily
- Patients should use Breo Ellipta regularly as prescribed and rinse their mouth after use to prevent oral thrush.
From the FDA Drug Label
BREO ELLIPTA is a prescription medicine used long term (chronic) to treat people with: Asthma: o BREO ELLIPTA is a prescription medicine used to prevent and control symptoms of asthma for better breathing and to prevent symptoms such as wheezing.
Brio Ellipta (fluticasone furoate/vilanterol) can be used for asthma management. It is a prescription medicine used to prevent and control symptoms of asthma for better breathing and to prevent symptoms such as wheezing 2. The medication is approved for use in patients aged 5 years and older, with different dosing recommendations based on age:
- Adult patients aged 18 years and older: 1 actuation of BREO ELLIPTA 100/25 mcg or BREO ELLIPTA 200/25 mcg once daily
- Pediatric patients aged 12 to 17 years: 1 actuation of BREO ELLIPTA 100/25 mcg once daily
- Pediatric patients aged 5 to 11 years: 1 actuation of BREO ELLIPTA 50/25 mcg once daily 2.
From the Research
Role of Brio Ellipta in Asthma Management
- Brio Ellipta, which contains fluticasone furoate and vilanterol, is used for the maintenance therapy of asthma 3.
- The Ellipta device is a novel blister strip dry powder inhaler with medium resistance and a consistent delivered dose across a range of inspiratory flow rates, making it easy to use and preferred by patients 4.
- Vilanterol is a long-acting beta2-agonist (LABA) that produces bronchodilation, while fluticasone furoate is an inhaled corticosteroid (ICS) that reduces airway inflammation and hyper-responsiveness 5.
Efficacy of Brio Ellipta in Asthma
- Studies have shown that once-daily fluticasone furoate/vilanterol (FF/VI) 100/25 mcg significantly improves lung function, including forced expiratory volume in 1 second (FEV1), and reduces symptoms and rescue medication use compared to fluticasone furoate alone 6.
- FF/VI 100/25 mcg has also been shown to improve health-related quality of life and reduce exacerbations in patients with asthma 5.
- A real-world study in Japan found that once-daily FF/VI 200/25 mcg combined with umeclidinium (a long-acting muscarinic antagonist) improved lung function tests, including FEV1 and peak flow, and asthma control in patients with asthma 7.