From the Guidelines
Inhaler treatments for respiratory conditions like asthma and COPD include short-acting beta-agonists (SABAs), long-acting beta-agonists (LABAs), inhaled corticosteroids (ICS), combination inhalers, and anticholinergics. The most recent and highest quality study, 1, recommends LABD maintenance therapy in all symptomatic patients with COPD confirmed by spirometry and single inhaler dual therapy LABD in those with moderate to severe dyspnea and/or poor health status. Some key medication classes and their uses are:
- Short-acting beta-agonists (SABAs) such as albuterol (Ventolin, ProAir) for quick relief of symptoms
- Long-acting beta-agonists (LABAs) like salmeterol (Serevent) and formoterol (Foradil) for long-term control of symptoms
- Inhaled corticosteroids (ICS) such as fluticasone (Flovent), budesonide (Pulmicort), and beclomethasone (QVAR) to reduce airway inflammation
- Combination inhalers that contain both an ICS and LABA, like fluticasone/salmeterol (Advair), budesonide/formoterol (Symbicort), or mometasone/formoterol (Dulera)
- Anticholinergics like tiotropium (Spiriva) and umeclidinium (Incruse) for COPD specifically, to relax airway muscles through a different mechanism. Proper inhaler technique is crucial for medication effectiveness, and treatment regimens are typically stepped up or down based on symptom control, with rescue inhalers used for breakthrough symptoms and controller medications taken regularly to prevent exacerbations, as supported by earlier studies 1.
From the FDA Drug Label
Wixela Inhub® (fluticasone propionate and salmeterol inhalation powder), for oral inhalation use
INDICATIONS AND USAGE Wixela Inhub® is a combination product containing a corticosteroid and a long-acting beta2-adrenergic agonist (LABA) indicated for: • Twice-daily treatment of asthma in patients aged 4 years and older. • Maintenance treatment of airflow obstruction and reducing exacerbations in patients with chronic obstructive pulmonary disease (COPD).
The various inhaler treatments for respiratory conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD) include:
- Combination products: Containing a corticosteroid and a long-acting beta2-adrenergic agonist (LABA), such as Wixela Inhub® (fluticasone propionate and salmeterol inhalation powder)
- Corticosteroids: Such as fluticasone propionate
- LABAs: Such as salmeterol 2 2
From the Research
Inhaler Treatments for Respiratory Conditions
The various inhaler treatments for respiratory conditions such as asthma and Chronic Obstructive Pulmonary Disease (COPD) include:
- Inhaled corticosteroids (ICS) and long-acting beta agonists (LABAs) combination therapy, such as fluticasone propionate and salmeterol 3, 4
- Fixed-dose combinations of ICS/LABA, including budesonide/formoterol (Symbicort) and salmeterol/fluticasone propionate (SeretideTM) 4
- Combination fluticasone and salmeterol versus fixed dose combination budesonide and formoterol for chronic asthma in adults and children 5
- Budesonide/formoterol, which has a fast onset of effect compared to salmeterol/fluticasone and salbutamol in patients with COPD and reversible airway obstruction 6
Types of Inhalers
Some specific types of inhalers mentioned in the studies include:
- Advair Diskus® (fluticasone propionate and salmeterol) 3
- Wixela™ Inhub™ (a generic version of Advair Diskus) 3
- Symbicort (budesonide/formoterol) 4, 5
- SeretideTM (salmeterol/fluticasone propionate) 4
Key Findings
Key findings from the studies include:
- Combination therapy with ICS and LABAs is effective in controlling asthma and COPD symptoms 3, 4
- Fixed-dose combinations of ICS/LABA are commonly prescribed for both conditions 4
- Budesonide/formoterol has a fast onset of effect compared to salmeterol/fluticasone and salbutamol in patients with COPD and reversible airway obstruction 6
- The safety profile of regular formoterol in combination with budesonide, beclomethasone, fluticasone, or mometasone is similar to that of salmeterol in combination with fluticasone or budesonide 7