From the Guidelines
The main difference between Anoro and Trelegy for COPD treatment is that Trelegy contains three active ingredients (fluticasone furoate, umeclidinium, and vilanterol), while Anoro contains only two (umeclidinium and vilanterol). Trelegy includes an inhaled corticosteroid (fluticasone furoate) in addition to the long-acting muscarinic antagonist (LAMA) umeclidinium and long-acting beta-agonist (LABA) vilanterol found in both medications. This makes Trelegy more appropriate for patients with more severe COPD who experience frequent exacerbations, as the corticosteroid component helps reduce inflammation and exacerbation risk 1. Anoro is typically used for patients with moderate COPD who need bronchodilation but don't necessarily require the anti-inflammatory effects of a steroid.
Key Differences and Considerations
- Trelegy is more suitable for patients with severe COPD and frequent exacerbations due to its corticosteroid component.
- Anoro is typically used for patients with moderate COPD who require bronchodilation without the need for anti-inflammatory effects.
- Both medications are administered once daily via inhalation devices.
- Side effects for both include dry mouth, headache, and upper respiratory infections, with Trelegy potentially having additional steroid-related side effects such as increased risk of pneumonia and oral thrush 1.
- The choice between these medications should be based on the severity of COPD symptoms, exacerbation history, and individual patient factors, with treatment typically starting with bronchodilators alone (like Anoro) and progressing to triple therapy (like Trelegy) if symptoms remain uncontrolled 1.
Treatment Approach
The approach to treating COPD with these medications involves considering the patient's disease severity and history of exacerbations. For patients with stable moderate to very severe COPD, maintenance combination inhaled corticosteroid/long-acting β-agonist therapy or inhaled long-acting anticholinergic monotherapy is recommended to prevent acute exacerbations of COPD 1. The inclusion of an inhaled corticosteroid in Trelegy makes it a preferable option for patients who would benefit from the reduction of inflammation and exacerbation risk associated with corticosteroid use. However, the decision should also consider the potential increased risk of adverse events such as pneumonia associated with inhaled corticosteroid use 1.
From the Research
Overview of Anoro and Trelegy
- Anoro is a combination of umeclidinium and vilanterol, used for the treatment of chronic obstructive pulmonary disease (COPD) 2.
- Trelegy is a combination of fluticasone furoate, umeclidinium, and vilanterol, also used for the treatment of COPD 2.
Key Differences
- The main difference between Anoro and Trelegy is the presence of fluticasone furoate, an inhaled corticosteroid (ICS), in Trelegy 3.
- Trelegy is a triple therapy, combining a LAMA (umeclidinium), a LABA (vilanterol), and an ICS (fluticasone furoate), while Anoro is a dual therapy, combining a LAMA (umeclidinium) and a LABA (vilanterol) 4.
Efficacy and Safety
- Studies have shown that Trelegy (fluticasone furoate/umeclidinium/vilanterol) reduces the risk of all-cause mortality and exacerbations in patients with COPD compared to Anoro (umeclidinium/vilanterol) 3.
- The safety profile of Trelegy is similar to that of Anoro, with no excess cardiovascular effects or pneumonia 4.
Treatment Recommendations
- Trelegy is recommended for patients with severe COPD who remain symptomatic and/or have frequent exacerbations despite dual therapies 4.
- Anoro is recommended for patients with COPD who require dual therapy with a LAMA and a LABA 2.