What is the recommended treatment for patients with Chronic Obstructive Pulmonary Disease (COPD) or asthma using the ELLIPTA inhaler?

Treatment Recommendations for COPD and Asthma Using ELLIPTA Inhaler

For patients with COPD or asthma, the ELLIPTA inhaler should be used to deliver appropriate medication based on disease severity, with LAMA/LABA combinations recommended for most COPD patients and ICS/LABA combinations for asthma patients, administered once daily.

COPD Treatment Algorithm with ELLIPTA

Mild COPD (FEV1 >80%, low symptom burden)

• First-line: LAMA or LABA monotherapy via ELLIPTA 1
  • Options include umeclidinium 62.5 mcg (LAMA) once daily
• For as-needed symptom relief: Short-acting bronchodilator (SABA) as rescue medication

Moderate to Severe COPD (FEV1 <80%, higher symptom burden)

• First-line: LAMA/LABA dual therapy via ELLIPTA 1
  • Recommended: Umeclidinium/vilanterol 62.5/25 mcg once daily
• For patients with CAT ≥10 or mMRC ≥2: LAMA/LABA is preferred over ICS/LABA due to better lung function improvement and lower pneumonia risk 1

High Exacerbation Risk COPD

• First-line: Triple therapy with ICS/LAMA/LABA via ELLIPTA 1
  • Recommended: Fluticasone furoate/umeclidinium/vilanterol in a single inhaler once daily
• This approach is particularly beneficial for patients with ≥2 moderate exacerbations or ≥1 severe exacerbation in the previous year 1

Asthma Treatment Algorithm with ELLIPTA

For Adults and Adolescents (12+ years)

• Recommended: Fluticasone furoate/vilanterol (FF/VI) via ELLIPTA 2
  • Starting dose: 100/25 mcg once daily
  • For inadequate control: Consider increasing to 200/25 mcg once daily
• The maximum recommended dose is one inhalation of 200/25 mcg once daily 2

For Children (5-11 years)

• Recommended: Fluticasone furoate/vilanterol 50/25 mcg once daily 2

Proper ELLIPTA Inhaler Technique

1. Open the cover by sliding it down until you hear a "click"
2. Do not shake the inhaler
3. Breathe out gently away from the inhaler
4. Place the mouthpiece between lips and inhale deeply and steadily
5. Remove the inhaler and hold breath for about 3-4 seconds
6. Close the cover after use

Advantages of ELLIPTA for COPD and Asthma Patients

• Ease of use: The ELLIPTA inhaler has demonstrated fewer critical errors compared to other devices (only 5-14% of COPD patients made critical errors compared to 44-60% with other devices) 3
• Patient preference: Multiple studies show patients prefer ELLIPTA over other inhalers including DISKUS, MDI, Turbuhaler, HandiHaler, and Breezhaler 4, 3, 5
• Consistent dose delivery: The ELLIPTA provides consistent delivered dose across a range of inspiratory flow rates (41.6-136.9 L/min), making it suitable for patients with varying degrees of airflow limitation 6
• Once-daily dosing: All medications delivered via ELLIPTA are administered once daily, which may improve adherence 2, 7

Important Clinical Considerations

• ELLIPTA is not indicated for relief of acute bronchospasm - patients should always have a rescue inhaler (e.g., albuterol) available for immediate symptom relief 2
• For patients transitioning from nebulized therapy to ELLIPTA, ensure they are stable before switching 8
• Regular follow-up is essential to assess response to therapy and adjust treatment as needed
• When initiating ELLIPTA, provide proper education on inhaler technique as this significantly reduces critical errors 3

The ELLIPTA inhaler's ease of use, consistent dose delivery, and once-daily dosing make it an excellent choice for maintenance therapy in both COPD and asthma, with medication selection based on disease severity, symptom burden, and exacerbation risk.